Organization
MOLINA MEDICAL GROUP OF MICHIGAN, PC
Active
Organization
MOLINA MEDICAL GROUP OF MICHIGAN, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GLORIA CALDERON (VP, CLINIC OPERATIONS)
(562) 499-6191
Entity
Organization
Contact information
Practice address
4700 SCHAEFER RD, DEARBORN, MI 48126-3655
(313) 581-2600
(313) 581-0228
Mailing address
200 OCEANGATE, SUITE 100, LONG BEACH, CA 90802-4317
(562) 499-6191
(562) 499-6171
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
23D0367347
MI
Other
Enumeration date
10/10/2016
Last updated
10/21/2016
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