JOSEPH M MOLINA MD PROFESSIONAL CORPORATION SOUTHERN CALIFORNIA (NPI# 1720465206) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1720465206 |
| Entity Type | Organization |
| Organization Name | JOSEPH M MOLINA MD PROFESSIONAL CORPORATION SOUTHERN CALIFORNIA |
| Other Organization Name | MOLINA SAN BERNARDINO |
| Practice Address |
190 E Highland Ave San Bernardino CA 92404-3658 |
| Mailing Address |
5626 Oberlin Dr Suite 110 San Diego CA 92121-1705 |
| Practice Telephone | 9098824788 |
| Enumeration Date | 2015-05-04 |
| Last Update Date | 2015-05-04 |
| 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 | A110824 | CA | Suppliers |
| Other Name | Type Code |
|---|---|
| Molina San Bernardino | 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 |
| 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 |
| 1124405758 | Joseph M Molina Md Professional Corporation Southern California | Non-Pharmacy Dispensing Site | 790 E Foothill Blvd, Rialto, CA 92376-5269 | 2015-05-04 |
| Street Address |
190 E HIGHLAND AVE |
| City | SAN BERNARDINO |
| State | CA |
| Zip Code | 92404-3658 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699717306 | Renato G Rada | Family Medicine | 190 E Highland Ave, San Bernardino, CA 92404-3658 | 2006-06-10 |
| 1205393238 | Unicare Community Health Center Inc | Clinic/Center | 190 E Highland Ave, San Bernardino, CA 92404-3658 | 2019-02-26 |
| 1972875680 | Joseph M Molina Md Professional Corporation-southern California | Pediatrics | 190 E Highland Ave, San Bernardino, CA 92404-3658 | 2012-01-27 |
| 1760787030 | Mary Edem | Nurse Practitioner | 190 E Highland Ave, San Bernardino, CA 92404-3658 | 2011-01-18 |
| 1922237916 | Roshanda Clemons | Pediatrics | 190 E Highland Ave, San Bernardino, CA 92404-3658 | 2009-07-10 |
| 1568691293 | Ngoc Thi Bich Nguyen | Pediatrics | 190 E Highland Ave, San Bernardino, CA 92404-3658 | 2009-07-01 |
| 1811012636 | Gloria Elsie Morrow | Psychologist | 190 E Highland Ave, San Bernardino, CA 92404-3658 | 2007-03-20 |
| 1972651289 | Maria Elena Terrazas | Physician Assistant | 190 E Highland Ave, San Bernardino, CA 92404-3658 | 2007-01-05 |
| 1861507006 | Molina Healthcare of California | Internal Medicine | 190 E Highland Ave, San Bernardino, CA 92404-3658 | 2006-08-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740849363 | Danniella Alexandra Murillo | Physician Assistant | 2101 North Waterman Ave, San Bernardino, CA 92404 | 2019-06-07 |
| 1902377484 | Shauntel Renee Nelson | Student in an Organized Health Care Education/Training Program | 1481 N. Windsor Dr., San Bernardino, CA 92404 | 2018-12-10 |
| 1487123584 | Garrett M Grigg | Licensed Psychiatric Technician | 1481 N Windsor Dr, San Bernardino, CA 92404 | 2018-11-19 |
| 1881163434 | James Dean Anders | Counselor | 1481 Windsor Drive, San Bernardino, CA 92404 | 2018-11-13 |
| 1043703564 | Samantha Makpaiboonvatana | Optometrist | 1909 N Waterman Ave Ste 3, San Bernardino, CA 92404 | 2018-06-09 |
| 1861981623 | Christopher Windham | Behavior Technician | 2460 Fremontia Dr, San Bernardino, CA 92404 | 2018-05-08 |
| 1891145041 | Cynthia Lusy Gastelum | Marriage & Family Therapist | 1885 E Lynwood Dr Rm Se3, San Bernardino, CA 92404 | 2016-06-20 |
| 1336598259 | Foundation Enterprises LLC | Non-emergency Medical Transport (VAN) | 1663 Date Pl., #30390, San Bernardino, CA 92404 | 2016-06-10 |
| 1881042877 | Helen Ann Thompson | Speech-Language Pathologist | 1311 E. State St., San Bernardo, CA 92404 | 2016-05-31 |
| 1366839938 | Lanecia Richardson | Counselor | 135 Paul Drive, San Rafeal, CA 92404 | 2015-04-22 |
| Find all providers in zip 92404 | ||||
| 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 |
|---|---|---|---|---|
| 1982083150 | R Roland Lopez, M.d., Inc. | Non-Pharmacy Dispensing Site | 1535 S D St, Suite 240, San Bernardino, CA 92408-3253 | 2015-05-21 |
| 1700290137 | Arj Medical, Inc. | Non-Pharmacy Dispensing Site | 155 W Hospitality Ln, San Bernardino, CA 92408-3305 | 2014-06-13 |
| 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 | ||||
| City | SAN BERNARDINO |
| Zip Code | 92404 |
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.