Organization
MOLINA HEALTHCARE OF NEW MEXICO
Active
Parent organization
MOLINA HEALTHCARE
Organization subpart
Yes
Provider details
NPI number
Legal business name
MOLINA HEALTHCARE
Authorized official
DANIEL SORRELLS (PLAN PRESIDENT-MHNM)
(888) 562-5442
Entity
Organization
Contact information
Practice address
400 TIJERAS AVE NW, ALBUQUERQUE, NM 87102-3234
(888) 562-5441
Mailing address
200 OCEANGATE STE 100, LONG BEACH, CA 90802-4317
(888) 562-5442
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
207R00000X
Internal Medicine Physician
—
—
Other
Enumeration date
10/26/2017
Last updated
10/26/2017
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