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NPI Code Detail

MEDICARE: CARLOS A MOLINA

MEDICARE: CARLOS A MOLINA
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
13747P1801XPersonal Care Attendant

General Provider Information

NPI Number : 1669094744
Entity Type Code : Individual
Provider Name (Legal Business Name) : CARLOS A MOLINA
Provider Business Mailing Address
First Line : PO BOX 8459
Second Line :
City : PORTLAND
State : OR
Zip : 97207-8459
Country : US
Telephone Number : 503-238-0769
Fax Number :
Provider Business Practice Location Address
First Line : 7621 N PORTSMOUTH AVE
Second Line :
City : PORTLAND
State : OR
Zip : 97203-5953
Country : US
Telephone Number : 503-240-7599
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/12/2020
Last Update Date : 05/12/2020

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Directions to “ CARLOS A MOLINA ” Practice Location

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