# JOSEPH M MOLINA MD PROFESSIONAL CORPORATION - SOUTHERN CALIFORNIA

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

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

## Provider details

- **NPI number:** 1780005140
- **Authorized official:** GLORIA CALDERON (VP, CLINIC OPERATIONS)
- **Authorized official phone:** (562) 499-6191

## Contact information

- **Practice address:** 1409 S STATE ST, OREM, UT 84097-7703
- **Practice address phone:** (562) 499-6191
- **Practice address fax:** (562) 499-6171
- **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 | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |
| 208000000X | Pediatrics Physician | — | NULL | — |
| 208000000X | Pediatrics Physician | — | — | — |
| 363A00000X | Physician Assistant | — | NULL | — |
| 363A00000X | Physician Assistant | — | — | — |
| 363L00000X | Nurse Practitioner | — | NULL | — |
| 363L00000X | Nurse Practitioner | — | — | — |

## Other

- **Enumeration date:** 01/02/2014
- **Last updated:** 05/27/2014