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NPI Code Detail

MEDICARE: MOLINA HEALTHCARE OF CALIFORNIA

MEDICARE: MOLINA HEALTHCARE OF 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
1207R00000XInternal Medicine Physician
2207Q00000XFamily Medicine Physician

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1255446464
Entity Type Code : Organization
Provider Name (Legal Business Name) : MOLINA HEALTHCARE OF CALIFORNIA
Provider Business Mailing Address
First Line : 200 OCEANGATE STE 100
Second Line :
City : LONG BEACH
State : CA
Zip : 90802-4317
Country : US
Telephone Number : 562-499-6191
Fax Number :
Provider Business Practice Location Address
First Line : 7777 SUNRISE BLVD STE 2500
Second Line :
City : CITRUS HEIGHTS
State : CA
Zip : 95610-2372
Country : US
Telephone Number : 916-722-2227
Fax Number : 877-860-5422
Authorized Official
Title or Position : V.P. FINANCE
Name : MATTHEW SCHUEREN
Credential :
Telephone Number : 888-562-5442
Provider Enumeration Date : 08/20/2006
Last Update Date : 12/06/2017

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Practice Location Address:
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1669401386 — DR. KULVINDER SINGH BOPARAI M.D.
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1417261165 — ANNA PETRIK
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7777 SUNRISE BLVD STE 2500
CITRUS HEIGHTS, CA
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Practice Fax:
1205178506 — PRIYADHARSHINI NARAYANAN MD
Practice Location Address:
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CITRUS HEIGHTS, CA
95610-2372
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1730643990 — WELLSPACE HEALTH
Practice Location Address:
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1700851896 — DR. POLINA VOLODARSKAYA DO
Practice Location Address:
7777 SUNRISE BLVD. #2500
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Practice Fax: 877-860-5422

Directions to “MOLINA HEALTHCARE OF CALIFORNIA ” Practice Location

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