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 PLANNER, RESEARCH & DEV.)
(562) 499-6191
Entity
Organization
Contact information
Practice address
MOLINA MEDICAL CENTERS - SMO, 954 SACRAMENTO AVENUE, W. SACRAMENTO, CA 95605-1904
(916) 373-1495
(916) 373-0954
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
—
GR004265M
—
CA
Enumeration date
05/11/2007
Last updated
08/22/2020
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