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Organization
MOLINA MEDICAL CENTERS
Active
Organization
MOLINA MEDICAL CENTERS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. EDWARD KIM (PRESIDENT)
(562) 499-6191
Entity
Organization
Contact information
Practice address
4354 LATHAM ST, #100, RIVERSIDE, CA 92501-1777
(951) 787-1101
(951) 787-0719
Mailing address
200 OCEANGATE, #100, LONG BEACH, CA 90802-4317
(562) 499-6191
(562) 499-6171
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR004265C
—
CA
Enumeration date
08/19/2006
Last updated
05/21/2008
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