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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 48126-3698
(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
207K00000X
Allergy & Immunology Physician
207N00000X
Dermatology Physician
207P00000X
Emergency Medicine Physician
207R00000X
Internal Medicine Physician
Primary
207RC0000X
Cardiovascular Disease Physician
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
207RG0100X
Gastroenterology Physician
207RN0300X
Nephrology Physician
207V00000X
Obstetrics & Gynecology Physician
207Y00000X
Otolaryngology Physician
208000000X
Pediatrics Physician
208100000X
Physical Medicine & Rehabilitation Physician
2084N0400X
Neurology Physician
208600000X
Surgery Physician
208800000X
Urology Physician

Other

Enumeration date
06/03/2016
Last updated
06/03/2016
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