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Organization
MOLINA HEALTHCARE OF NEW MEXICO
Active
Organization
MOLINA HEALTHCARE OF NEW MEXICO
Active
Parent organization
MOLINA HEALTHCARE
Organization subpart
Yes
Provider details
NPI number
Legal business name
MOLINA HEALTHCARE
Authorized official
DANIEL SORRELLS (PLAN PRESIDENT-MHNM)
(888) 562-5442
Entity
Organization
Contact information
Practice address
400 TIJERAS AVE NW, ALBUQUERQUE, NM 87102-3234
(888) 562-5441
Mailing address
200 OCEANGATE STE 100, LONG BEACH, CA 90802-4317
(888) 562-5442
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
207R00000X
Internal Medicine Physician
—
—
Other
Enumeration date
10/26/2017
Last updated
10/26/2017
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