Organization
MOLINA HEALTHCARE OF CALIFORNIA
Active
Other names
Molina Medical Centers
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DENNIS WAYNE EVANS (STRATEGIC PLANER, RESEARCH AND DEV.)
(562) 499-6191
Entity
Organization
Contact information
Practice address
MOLINA MEDICAL CENTERS - SMO, 3946 NORWOOD AVENUE, SACRAMENTO, CA 95838-3300
(916) 564-0521
(916) 564-1528
Mailing address
MOLINA MEDICAL CENTERS - SMO, ONE GOLDEN SHORE, LONG BEACH, CA 90802-4202
(562) 499-6191
(562) 499-6171
Taxonomy
Speciality
Code
Description
License number
State
332900000X
Non-Pharmacy Dispensing Site
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR004265Q
—
CA
Enumeration date
05/11/2007
Last updated
08/22/2020
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