JOSEPH M MOLINA MD PROFESSIONAL CORPORATION-SOUTHERN CALIFORNIA (NPI# 1700158417) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1700158417 |
| Entity Type | Organization |
| Organization Name | JOSEPH M MOLINA MD PROFESSIONAL CORPORATION-SOUTHERN CALIFORNIA |
| Other Organization Name | MOLINA MEDICAL GROUP OF SOUTHERN CALIFORNIA |
| Practice Address |
15 Sw Everett Mall Way Suite A Everett WA 98204-2715 |
| Mailing Address |
200 Oceangate Suite 100 Long Beach CA 90802-4317 |
| Practice Telephone | 4253486727 |
| Practice Fax Number | 8778602991 |
| Mailing Telephone | 5624996191 |
| Mailing Fax Number | 5624996171 |
| Enumeration Date | 2012-01-27 |
| Last Update Date | 2013-06-18 |
| Authorized Official Name | GLORIA CALDERON (VICE PRESIDENT-CLINIC OPERATIONS) |
| Authorized Official Telephone | 5624917053 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207R00000X | Internal Medicine | WA | Allopathic & Osteopathic Physicians | |
| Y | 207Q00000X | Family Medicine | WA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | APPROVED/PROVIDERONE | 05 |
| Other Name | Type Code |
|---|---|
| Molina Medical Group of Southern California | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558633255 | Joseph M Molina Md Professional Corporation-southern California | Pediatrics | 790 E Foothill Blvd, Suite D, Rialto, CA 92376-5269 | 2012-01-27 |
| 1982976692 | Joseph M Molina Md Professional Corporation-southern California | Internal Medicine | 445 E. Anaheim Street, #h, Wilmington, CA 90744-4600 | 2012-01-27 |
| 1588935233 | Joseph M Molina Md Professional Corporation-southern California | Pediatrics | 5549 Van Buren Blvd., Riverside, CA 92503-2068 | 2012-01-25 |
| 1124399860 | Joseph M Molina Md Professional Corporation-southern California | Pediatrics | 24853 Alessandro Blvd., #4, Moreno Valley, CA 92553-6102 | 2012-01-25 |
| 1215208962 | Joseph M Molina Md Professional Corporation-southern California | Pediatrics | 540 E. Artesia Boulevard, Long Beach, CA 90805-1476 | 2012-01-25 |
| 1801177944 | Joseph M Molina Md Professional Corporation-southern California | Pediatrics | 1714 Saint Michaels Dr, #1, Santa Fe, NM 87505-7617 | 2011-09-02 |
| 1508279779 | Joseph M Molina Md Professional Corporation-southern California | Pediatrics | 7777 Sunrise Blvd, Suite 2500, Citrus Heights, CA 95610-2300 | 2014-06-05 |
| 1235542408 | Joseph M Molina Md Professional Corporation-southern California | Pediatrics | 3946 Norwood Ave, Sacramento, CA 95838-3300 | 2014-06-05 |
| 1417360686 | Joseph M Molina Md Professional Corporation-southern California | Pediatrics | 6339 Mack Rd, Sacramento, CA 95823-4655 | 2014-06-05 |
| 1326451592 | Joseph M Molina Md Professional Corporation-southern California | Pediatrics | 3234 Marysville Blvd, Sacramento, CA 95815-1411 | 2014-06-05 |
| Street Address |
15 SW EVERETT MALL WAY SUITE A |
| City | EVERETT |
| State | WA |
| Zip Code | 98204-2715 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710946108 | Ayad Joseph Dawood | Internal Medicine | 15 Sw Everett Mall Way, Suite A, Everett, WA 98204-2715 | 2006-03-22 |
| 1457785750 | Allison Kate Berglin | Nurse Practitioner | 15 Sw Everett Mall Way, Suite A, Everett, WA 98204-2715 | 2013-08-22 |
| 1891042180 | Christopher Soterakopoulos | Physical Therapist | 15 Sw Everett Mall Way, Ste G, Everett, WA 98204-2715 | 2012-08-06 |
| 1073873808 | Ryan Everett Culp | Chiropractor | 15 Sw Everett Mall Way, Ste G, Everett, WA 98204-2715 | 2012-05-27 |
| 1467739326 | Jimmy Greer | Chiropractor | 15 Sw Everett Mall Way, Ste G, Everett, WA 98204-2715 | 2011-11-07 |
| 1235415670 | Diana Lam | Chiropractor | 15 Sw Everett Mall Way, Ste G, Everett, WA 98204-2715 | 2011-10-31 |
| 1891000725 | Molina Healthcare of Washington, Inc | Pediatrics | 15 Sw Everett Mall Way, Suite A, Everett, WA 98208-2777 | 2010-08-16 |
| 1871642082 | Thomas Eugene Horst | Family Medicine | 15 Sw Everett Mall Way, Suite A, Everett, WA 98204-2715 | 2007-01-09 |
| 1841357621 | Magdalena M Walczak | Family Medicine | 15 Sw Everett Mall Way, Suite A, Everett, WA 98204-2715 | 2007-01-02 |
| 1356394258 | Marcia M Wharton | Family Medicine | 15 Sw Everett Mall Way, Everett, WA 98204-2715 | 2006-05-19 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588262869 | Samuel Lin, Nd, Pllc | Naturopath | 13410 Hwy 99, Ste 202, Everett, WA 98204 | 2020-10-09 |
| 1003458225 | Svetlana A Gayevskaya | Technician | 12605 E. Gibson Rd. Unit # 87, Everett, WA 98204 | 2019-10-09 |
| 1821555921 | Kymberly Ann Shepherd | Counselor | 1011 128th St Sw, E201, Everett, WA 98204 | 2019-02-25 |
| 1609392653 | Mohammed Bayo | Nurse's Aide | 9217 4th Ave. West, Everett, WA 98204 | 2017-08-21 |
| 1962951582 | Abreham Shoangizaw | Pharmacist | 802 134th S B C, Everett, WA 98204 | 2016-09-23 |
| 1588012694 | Tammy J Laird | Counselor | 9300 Evergreen Way, Everett, WA 98204 | 2016-05-31 |
| 1083011282 | Bernadette K Stanek | Massage Therapist | 13410 Washington 99 #204, Everett, WA 98204 | 2014-12-03 |
| 1356771067 | Dixon Stopper | Hearing Instrument Specialist | 12811 8th Ave W Ste B203, Everett, WA 98204 | 2013-11-15 |
| 1427312495 | Dan Huy Nguyen | Respiratory Therapist, Registered | 1919 112th Street Southwest, Everett, WA 98204 | 2012-06-25 |
| 1942571880 | Alena A Klimenko | Specialist | 12811 8th- Ave W, Suite B-103, Everett, WA 98204 | 2012-01-24 |
| Find all providers in zip 98204 | ||||
| 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 |
|---|---|---|---|---|
| 1649882275 | Blair Regenerative Medicine LLC | Family Medicine | 201 Hospital Dr Ste 2, Everett, PA 15537-7019 | 2020-08-17 |
| 1366856569 | Bowhee Sohn Gwak | Family Medicine | 12800 Bothell Everett Hwy Ste 160, Everett, WA 98208-6644 | 2014-06-16 |
| 1518392513 | Bernadette Flynn | Family Medicine | 41 W 1st St, Everett, PA 15537-1103 | 2013-09-09 |
| 1801164058 | Charles William Starbuck | Family Medicine | 3605 Shore Avenue, Everett, WA 98203-1209 | 2011-12-02 |
| 1649498049 | Western Washington Medical Group, Inc Ps | Family Medicine | 4225 Hoyt Ave Ste B, Everett, WA 98203-2351 | 2007-04-23 |
| 1689790792 | Del Whetstone | Family Medicine | 9629 Evergreen Way, Suite 102, Everett, WA 98204-7198 | 2007-03-21 |
| 1497843213 | Vincent M. Koike | Family Medicine | 7601 Evergreen Way, B-6, Everett, WA 98203 | 2006-10-10 |
| 1295820942 | North Creek Medicine Inc P S | Family Medicine | 210 128th St Se, Everett, WA 98208-6338 | 2006-10-04 |
| 1376644518 | Thomas G. Pautler | Family Medicine | 5007 Claremont Way, Everett, WA 98203-3321 | 2006-09-26 |
| 1487662581 | Allison M Cole | Family Medicine | 1410 Broadway, Everett, WA 98201-1720 | 2006-08-04 |
| Find all providers in EVERETT | ||||
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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.