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NPI Code Detail

MEDICARE: JOSEPH M MOLINA MD PROFESSIONAL CORPORATION- SOUTHERN CALIFORNIA

MEDICARE: JOSEPH M MOLINA MD PROFESSIONAL CORPORATION- SOUTHERN CALIFORNIA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine Physician
2207R00000XInternal Medicine Physician
3208M00000XHospitalist Physician

General Provider Information

NPI Number : 1043752371
Entity Type Code : Organization
Provider Name (Legal Business Name) : JOSEPH M MOLINA MD PROFESSIONAL CORPORATION- SOUTHERN CALIFORNIA
Provider Business Mailing Address
First Line : 200 OCEANGATE
Second Line : SUITE 100
City : LONG BEACH
State : CA
Zip : 90802-4302
Country : US
Telephone Number : 562-499-6191
Fax Number : 562-499-6171
Provider Business Practice Location Address
First Line : 200 OCEANGATE
Second Line : SUITE 100
City : LONG BEACH
State : CA
Zip : 90802-4302
Country : US
Telephone Number : 562-499-6191
Fax Number : 562-499-6171
Authorized Official
Title or Position : PRESIDENT, MMM
Name : GLORIA CALDERON
Credential :
Telephone Number : 562-499-6191
Provider Enumeration Date : 11/17/2016
Last Update Date : 11/17/2016

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Directions to “JOSEPH M MOLINA MD PROFESSIONAL CORPORATION- SOUTHERN CALIFORNIA ” Practice Location

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