# JOSEPH M MOLINA MD PROFESSIONAL CORPORATION-SOUTHERN CALIFORNIA

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Molina Medical Group of Southern California
- **Organization subpart:** No

## Provider details

- **NPI number:** 1700158417
- **Authorized official:** GLORIA CALDERON (VICE PRESIDENT-CLINIC OPERATIONS)
- **Authorized official phone:** (562) 491-7053

## Contact information

- **Practice address:** 15 SW EVERETT MALL WAY, SUITE A, EVERETT, WA 98204-2715
- **Practice address phone:** (425) 348-6727
- **Practice address fax:** (877) 860-2991
- **Mailing address:** 200 OCEANGATE, SUITE 100, LONG BEACH, CA 90802-4317
- **Mailing address phone:** (562) 499-6191
- **Mailing address fax:** (562) 499-6171

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | WA | Yes |
| 207R00000X | Internal Medicine Physician | — | WA | — |

## Other

- **Enumeration date:** 01/27/2012
- **Last updated:** 06/18/2013