JOSEPH M MOLINA MD PROFESSIONAL CORPORATION SOUTHERN CALIFORNIA (NPI# 1265829436) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1265829436 |
| Entity Type | Organization |
| Organization Name | JOSEPH M MOLINA MD PROFESSIONAL CORPORATION SOUTHERN CALIFORNIA |
| Other Organization Name | MOLINA SOUTH RIVERSIDE |
| Practice Address |
107 N Mckinley St Corona CA 92879-6561 |
| Mailing Address |
9276 Scranton Rd Suite 100 San Diego CA 92121-7701 |
| Practice Telephone | 9513580141 |
| Enumeration Date | 2015-04-24 |
| Last Update Date | 2016-03-04 |
| Authorized Official Name | KENNY HEINE (VP OF OPERATIONS) |
| Authorized Official Telephone | 8589641506 |
| Is Organization Subpart | Y |
| Parent Organization Name | MEDVANTX, INC. |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 332900000X | Non-Pharmacy Dispensing Site | A85376 | CA | Suppliers |
| Other Name | Type Code |
|---|---|
| Molina South Riverside | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265836738 | Joseph M Molina Md Professional Corporation Southern California | Non-Pharmacy Dispensing Site | 1627 E Anaheim St, Long Beach, CA 90813-3809 | 2014-10-13 |
| 1336527597 | Joseph M Molina Md Professional Corporation Southern California | Non-Pharmacy Dispensing Site | 3234 Marysville Blvd, Sacramento, CA 95815-1411 | 2015-05-08 |
| 1154709301 | Joseph M Molina Md Professional Corporation Southern California | Non-Pharmacy Dispensing Site | 7777 Sunrise Blvd, Suite 2500, Citrus Heights, CA 95610-2300 | 2015-05-08 |
| 1699153858 | Joseph M Molina Md Professional Corporation Southern California | Non-Pharmacy Dispensing Site | 6339 Mack Rd, Sacramento, CA 95823-4655 | 2015-05-08 |
| 1881072049 | Joseph M Molina Md Professional Corporation Southern California | Non-Pharmacy Dispensing Site | 3946 Norwood Ave, Sacramento, CA 95838-3300 | 2015-05-08 |
| 1720465206 | Joseph M Molina Md Professional Corporation Southern California | Non-Pharmacy Dispensing Site | 190 E Highland Ave, San Bernardino, CA 92404-3658 | 2015-05-04 |
| 1538546015 | Joseph M Molina Md Professional Corporation Southern California | Non-Pharmacy Dispensing Site | 1181 N Mount Vernon Ave, Colton, CA 92324-2574 | 2015-05-04 |
| 1134506769 | Joseph M Molina Md Professional Corporation Southern California | Non-Pharmacy Dispensing Site | 14544 7th St, Victorville, CA 92395-4214 | 2015-05-04 |
| 1184001661 | Joseph M Molina Md Professional Corporation Southern California | Non-Pharmacy Dispensing Site | 5549 Van Buren Blvd, Riverside, CA 92503-2068 | 2015-05-04 |
| 1164809794 | Joseph M Molina Md Professional Corporation Southern California | Non-Pharmacy Dispensing Site | 24853 Alessandro Blvd, Suite 4, Moreno Valley, CA 92553-6102 | 2015-05-04 |
| Street Address |
107 N MCKINLEY ST |
| City | CORONA |
| State | CA |
| Zip Code | 92879-6561 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417991308 | Kareim H. Ali | Family Medicine | 107 N Mckinley St, Corona, CA 92879-6561 | 2006-06-15 |
| 1265999296 | Unicare Community Health Center Inc | Clinic/Center | 107 N Mckinley St, Corona, CA 92879-6561 | 2019-02-26 |
| 1891200366 | Molina Healthcare of Californa | Internal Medicine | 107 N Mckinley St, Corona, CA 92879-6561 | 2017-12-06 |
| 1154693869 | Joseph M Molina Md Professional Corporation-southern California | Pediatrics | 107 N Mckinley St, Corona, CA 92879-6561 | 2012-01-27 |
| 1245353309 | Marie Therese Georges | Nurse Practitioner | 107 N Mckinley St, Corona, CA 92879-6561 | 2007-04-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609475722 | Tahmea Henderson | Behavior Technician | 225 Rincon St. #219, Corona, CA 92879 | 2020-10-20 |
| 1669084828 | Kimberly O Harris | Behavioral Analyst | 225 E. Rincon St., Suite 219, Corona, CA 92879 | 2020-08-19 |
| 1962014381 | Mario Javier Herrera | Nurse Practitioner | 2130 High Pointe Dr, Apt 108, Corona, CA 92879 | 2020-08-18 |
| 1841659117 | Sleep & Cpap Center Inc | Clinical Medical Laboratory | 800 Magnolia Avenue, Suite 101, Corona, CA 92879 | 2016-02-16 |
| 1497151203 | Rafik Riad | Dentist | 817 Villa Montes Cir., Corona, CA 92879 | 2014-11-06 |
| 1326441551 | Ying Zhang Howe | Acupuncturist | 720 Magnolia Ave. #b3, Corona, CA 92879 | 2014-10-02 |
| 1164823233 | Piyush Sakhareliya | Pharmacist | 2230 Treemont Pl, Apt#207, Corona, CA 92879 | 2014-09-09 |
| 1053711739 | Brandice Medical Associates Inc | Clinical Medical Laboratory | 13575 Jasper Loop, Corona, CA 92879 | 2014-08-29 |
| 1982956058 | Nja Therapy Services, Inc. | Day Training, Developmentally Disabled Services | 1655 E 6th St Suite 204, Corona, CA 92879 | 2012-10-12 |
| 1356616064 | Corona Surgical LLC | Clinic/Center | 2370 Anselmo Drive, Corona, CA 92879 | 2012-03-13 |
| Find all providers in zip 92879 | ||||
| Taxonomy Code | 332900000X |
| Grouping | Suppliers |
| Classification | Non-Pharmacy Dispensing Site |
| A site other than a pharmacy that dispenses medicinal preparations under the supervision of a physician to patients for self-administration. (e.g. physician offices, ER, Urgent Care Centers, Rural Health Facilities, etc.) |
| Notes: Source: Developed by National Council for Prescription Drug Programs (NCPDP), National Home Infusion Association (NHIA), and Pharmacist Services Technical Advisory Coalition (PSTAC) [1/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073824199 | Mowbray P Hagan, Md, Inc | Non-Pharmacy Dispensing Site | 482 Corona Mall, Corona, CA 92879-1418 | 2010-06-23 |
| 1992751440 | Babak Roshdieh, M.d. Corp. | Non-Pharmacy Dispensing Site | 770 Magnolia Ave, Suite 2g, Corona, CA 92879-3120 | 2006-05-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982225496 | Artius Dermatology Associates PC | Non-Pharmacy Dispensing Site | 5757 Pacific Ave Ste 228, Stockton, CA 95207-5159 | 2020-05-06 |
| 1285268391 | Artius Dermatology Associates PC | Non-Pharmacy Dispensing Site | 1337 S Lovers Ln Ste D, Visalia, CA 93292-5249 | 2020-02-27 |
| 1790327732 | Triumph Specialties LLC | Non-Pharmacy Dispensing Site | 11100 Sepulveda Blvd # 8-519, Mission Hills, CA 91345-1131 | 2019-10-10 |
| 1487210365 | Artius Dermatology Associates P.C. | Non-Pharmacy Dispensing Site | 325 Mall Dr Ste 111, Hanford, CA 93230-5950 | 2019-05-15 |
| 1376030080 | Jane F Kardashian Md Inc | Non-Pharmacy Dispensing Site | 6769 N Fresno, Fresno, CA 93710 | 2018-04-18 |
| 1023511045 | Performance Health Medical Group | Non-Pharmacy Dispensing Site | 25431 Cabot Road Suite 118, Laguna Hills, CA 92653 | 2018-03-15 |
| 1043719206 | Southern California Orthopedic Institute L.p | Non-Pharmacy Dispensing Site | 4100 Empire Dr Ste 120, Bakersfield, CA 93309-0408 | 2018-02-02 |
| 1174032353 | Golden Gate Urology, Inc. | Non-Pharmacy Dispensing Site | 139 Townsend St Ste 100, San Francisco, CA 94107-1946 | 2017-09-20 |
| 1215462080 | Mas Management Group, Inc. | Non-Pharmacy Dispensing Site | 28446 Constellation Rd, Valencia, CA 91355-5081 | 2017-04-28 |
| 1730624719 | St. John's Well Child and Family Center Inc | Non-Pharmacy Dispensing Site | 326 W 23rd St, Los Angeles, CA 90007-2612 | 2016-12-29 |
| Find all providers with the same taxonomy | ||||
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| 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.