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Organization
JOSEPH M MOLINA MD PROFESSIONAL CORPORATION-SOUTHERN CALIFORNIA
Active
Organization
JOSEPH M MOLINA MD PROFESSIONAL CORPORATION-SOUTHERN CALIFORNIA
Active
Other names
Molina Medical Group of Southern CA
Organization subpart
No
Provider details
NPI number
Authorized official
GLORIA CALDERON (VICE PRESIDENT, CLINIC OPERATIONS)
(562) 491-7053
Entity
Organization
Contact information
Practice address
7317 CENTRAL AVE NE, ALBUQUERQUE, NM 87108-2015
(505) 200-3320
(877) 860-2279
Mailing address
200 OCEANGATE, SUITE 100, LONG BEACH, CA 90802-4302
(562) 499-6191
(562) 499-6171
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
207R00000X
Internal Medicine Physician
—
—
208000000X
Pediatrics Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
06939074
—
NM
Enumeration date
03/22/2012
Last updated
06/19/2013
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