MEDICARE: MOLA MEDICAL PRACTICE INC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	261QP2300X	Primary Care Clinic/Center
2	282N00000X	General Acute Care Hospital
3	207R00000X	Internal Medicine Physician

General Provider Information

NPI Number	:	1437763224
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MOLA MEDICAL PRACTICE INC

Provider Business Mailing Address
First Line	:	415 N CRESCENT DR STE 300
Second Line	:
City	:	BEVERLY HILLS
State	:	CA
Zip	:	90210-6814
Country	:	US
Telephone Number	:	310-657-9191
Fax Number	:

Provider Business Practice Location Address
First Line	:	415 N CRESCENT DR STE 300
Second Line	:
City	:	BEVERLY HILLS
State	:	CA
Zip	:	90210-6814
Country	:	US
Telephone Number	:	310-657-9191
Fax Number	:

Authorized Official
Title or Position	:	BILLING SUPERVISOR
Name	:	ARIEL WEEKS
Credential	:
Telephone Number	:	818-921-4127

Provider Enumeration Date	:	08/31/2020
Last Update Date	:	08/14/2025

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Directions to “MOLA MEDICAL PRACTICE INC ” Practice Location

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