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General NPI Number Information
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NPI Number | 1992663983
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Entity Type | Organization
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Legal Business Name | MOLINAS MEDICAL GROUP
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Dates
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Enumeration Date | 01/10/2026
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Last Update Date | 01/10/2026
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Provider Practice Location Address
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Address Line | 2219 S MOUNTAIN AVE
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City | ONTARIO
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State | CA
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Zip | 91762-6133
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Country | US
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Telephone | 832-996-6911
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Fax |
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Provider Business Mailing Address
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Address Line | 1159 SUNSET CT
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City | UPLAND
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State | CA
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Zip | 91784-1082
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | JERLYS SUAREZ LOPEZ
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Credential | MD
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Telephone | 832-996-6911
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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