JOSEPH M MOLINA MD PROFESSIONAL CORPORATION - SOUTHERN CALIFORNIA (NPI# 1063842334) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1063842334 |
| Entity Type | Organization |
| Organization Name | JOSEPH M MOLINA MD PROFESSIONAL CORPORATION - SOUTHERN CALIFORNIA |
| Other Organization Name | MOLINA MEDICAL GROUP OF SOUTHERN CALIFORNIA |
| Practice Address |
2196 West 3500 South, Suite C1 West Valley City UT 84119-3463 |
| Mailing Address |
200 Oceangate Ste 100 Long Beach CA 90802-4317 |
| Practice Telephone | 5624996191 |
| Practice Fax Number | 5624996171 |
| Mailing Telephone | 5624996191 |
| Mailing Fax Number | 5624996171 |
| Enumeration Date | 2013-11-22 |
| Last Update Date | 2014-05-27 |
| Authorized Official Name | GLORIA CALDERON (VP, CLINIC OPERATIONS) |
| Authorized Official Telephone | 5624996191 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 208000000X | Pediatrics | Allopathic & Osteopathic Physicians | ||
| N | 363A00000X | Physician Assistant | Physician Assistants & Advanced Practice Nursing Providers | ||
| N | 363L00000X | Nurse Practitioner | Physician Assistants & Advanced Practice Nursing Providers | ||
| Y | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| UT | EFF. 1/6/14 | 05 |
| Other Name | Type Code |
|---|---|
| Molina Medical Group of Southern California | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780005140 | Joseph M Molina Md Professional Corporation - Southern California | Pediatrics | 1409 S State St, Orem, UT 84097-7703 | 2014-01-02 |
| 1710478177 | Joseph M Molina Md Professional Corporation - Southern California | Obstetrics & Gynecology | 1151 E Walnut St, Ontario, CA 91761 | 2018-05-22 |
| 1093130080 | Joseph M Molina Md Professional Corporation - Southern California | Pediatrics | 2683 Pacific Ave, Long Beach, CA 90806-2610 | 2014-02-27 |
| 1518300912 | Joseph M Molina Md Professional Corporation - Southern California | Pediatrics | 14544 7th St, Victorville, CA 92395-4214 | 2013-04-16 |
| 1780937334 | Joseph M Molina Md Professional Corporation - Southern California | Pediatrics | 1181 N Mount Vernon Ave, Colton, CA 92324-2574 | 2012-10-19 |
| Street Address |
2196 WEST 3500 SOUTH, SUITE C1 |
| City | WEST VALLEY CITY |
| State | UT |
| Zip Code | 84119-3463 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164981932 | Arches Home Care, Inc. | Non-emergency Medical Transport (VAN) | 1385 W 2200 S Ste 203, West Valley City, UT 84119 | 2019-03-19 |
| 1629591003 | Exemplar Healthcare, Inc. | Hospice Care, Community Based | 1385 W 2200 S Ste 202, West Valley City, UT 84119 | 2017-07-18 |
| 1619358496 | Otto Bock Orthopedic Services LLC | Durable Medical Equipment & Medical Supplies | 2875 S Decker Lake Dr Ste 180, West Valley City, UT 84119 | 2015-06-17 |
| 1821407735 | Nathan William Stobbe | Dentist | 3280 W. 3500 S. Ste 3, West Valley, UT 84119 | 2014-08-05 |
| 1801209028 | Utah Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 3148 W 3500 S, West Valley City, UT 84119 | 2014-06-05 |
| 1215347935 | Karl Edward Jennings | Social Worker | 3901 S David Pl, West Valley City, UT 84119 | 2014-05-02 |
| 1750624672 | Shannon Quinn Dunlop | Registered Nurse | 2621 S 3270 W, West Valley City, UT 84119 | 2013-03-28 |
| 1215273529 | Holly H Tanski | Counselor | 5770 S. 1500 W. Bld A, Ihc Wasatch Canyons Campus, Salt Lake City, UT 84119 | 2012-12-14 |
| 1982955860 | Oquirrh Meadows Care and Rehab, Inc | Assisted Living Facility | 2948 So. Redwood Road, West Valley City, UT 84119 | 2012-10-02 |
| 1518235068 | Asjad Kaleem Mohammed | Pharmacist | 2290 S Redwood Road, Olive Pharmacy, Salt Lake City, UT 84119 | 2011-12-12 |
| Find all providers in zip 84119 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154942985 | Healing Center of Utah | Family Medicine | 2630 W 3500 S Ste B, West Valley City, UT 84119-3113 | 2020-05-04 |
| 1205293362 | Ihc Health Services Inc | Family Medicine | 5373 Lake Park Blvd, West Valley City, UT 84127 | 2016-01-20 |
| 1053653436 | Erin Bathurst Helms | Family Medicine | 5373 W Lake Park Blvd, West Valley City, UT 84120-8208 | 2013-03-23 |
| 1841497559 | Anh Tai Nguyen,md | Family Medicine | 1819 W 3500 S Ste 1c, West Valley City, UT 84119-3457 | 2007-06-27 |
| 1144340530 | Charles Wesley Miller | Family Medicine | 4052 West Pioneer Parkway, Suite 109, West Valley City, UT 84120-2063 | 2007-03-30 |
| 1023171014 | Ray Morris IIi | Family Medicine | 3465 So 4155 W Suite #2, West Valley City, UT 84120-2082 | 2006-12-19 |
| 1184657041 | Granger Medical Clinic, PC | Family Medicine | 2965 W. 3500 S., West Valley City, UT 84119 | 2006-07-07 |
| 1689619124 | Caryn Kendra Slack | Family Medicine | 4535 S 5600 W, West Valley City, UT 84120 | 2006-06-18 |
| 1356388730 | Lombardo F Palma | Family Medicine | 3540 S 4000 W, 200, West Valley City, UT 84120-3260 | 2006-06-02 |
| 1750348330 | Gregory A Stone | Family Medicine | 3336 S 4155 W, Suite 204, Western Hills Medical Clinic, West Valley City, UT 84120 | 2006-04-27 |
| Find all providers in WEST VALLEY CITY | ||||
| City | WEST VALLEY CITY |
| Zip Code | 84119 |
Please comment or provide details below to improve the information on JOSEPH M MOLINA MD PROFESSIONAL CORPORATION - SOUTHERN CALIFORNIA.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.