Healthcare Provider Details

I. General information

NPI: 1598691552
Provider Name (Legal Business Name): MOLITORIS MEDICAL JOHN MOLITORIS RARE FIND MEDICAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/18/2026
Last Update Date: 07/16/2026
Certification Date: 07/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10202 WASHINGTON BLVD
CULVER CITY CA
90232-3119
US

IV. Provider business mailing address

9950 WESTWANDA DR
BEVERLY HILLS CA
90210-1427
US

V. Phone/Fax

Practice location:
  • Phone: 310-482-8444
  • Fax: 310-388-1367
Mailing address:
  • Phone: 310-482-8444
  • Fax: 310-388-1367

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: JOHN MOLITORIS JR.
Title or Position: PRESIDENT
Credential: MD
Phone: 310-482-8444