Organization
BRISTOL PLAZA FAMILY MEDICINE, A PROFESSIONAL MEDICAL CORPORATION
Active
Other names
Bristol Plaza Family Medicine
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN MOLINA DO (PRESIDENT)
(714) 332-1800
Entity
Organization
Contact information
Practice address
3743 SO PLAZA DRIVE, SANTA ANA, CA 92704
(714) 332-1800
Mailing address
847 PALMYRITA AVENUE, SUITE A, RIVERSIDE, CA 92507
(951) 784-1400
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
20A7903
MEDICAL LICENSE
CA
Enumeration date
08/29/2014
Last updated
05/28/2015
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