JOSEPH M MOLINA MD PROFESSIONAL CORPORATION SOUTHERN CALIFORNIA (NPI# 1912394255) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1912394255 |
| Entity Type | Organization |
| Organization Name | JOSEPH M MOLINA MD PROFESSIONAL CORPORATION SOUTHERN CALIFORNIA |
| Other Organization Name | MOLINA FONTANA |
| Practice Address |
17500 Foothill Blvd Suite A2 Fontana CA 92335-3736 |
| Mailing Address |
5626 Oberlin Dr Suite 110 San Diego CA 92121-1705 |
| Practice Telephone | 9094280170 |
| Enumeration Date | 2015-04-24 |
| Last Update Date | 2015-04-24 |
| 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 | G45659 | CA | Suppliers |
| Other Name | Type Code |
|---|---|
| Molina Fontana | 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 |
17500 FOOTHILL BLVD SUITE A2 |
| City | FONTANA |
| State | CA |
| Zip Code | 92335-3736 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922037738 | Lannie Moy | Family Medicine | 17500 Foothill Blvd, #a-2, Fontana, CA 92335-3736 | 2006-07-02 |
| 1265860167 | Chidi R. Duru | Nurse Practitioner | 17500 Foothill Blvd, A-2, Fontana, CA 92335-3798 | 2013-10-31 |
| 1922379668 | Joseph M Molina Md Professional Corporation-southern California | Pediatrics | 17500 Foothill Blvd, #a-2, Fontana, CA 92335-3798 | 2012-01-25 |
| 1750510251 | Jennifer Josephine D'sa | Family Medicine | 17500 Foothill Blvd, #a-2, Fontana, CA 92335-3798 | 2009-07-07 |
| 1487803433 | Laura Y. Jimenez, Dds Prof. Dental Corp | Dentist | 17500 Foothill Blvd, Fontana, CA 92335-3736 | 2008-09-15 |
| 1770772071 | Enrico A Melson | Family Medicine | 17500 Foothill Blvd, Suite A-2, Fontana, CA 92335-3798 | 2007-10-23 |
| 1487786323 | Ricardo Villanueva | Dentist | 17500 Foothill Blvd, Suite C-2, Fontana, CA 92335-3736 | 2007-03-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104425131 | Hossein Malakooti A Dental Corporation | Clinic/Center | 16540 Merrill Ave, Fontana, CA 92335 | 2020-10-21 |
| 1790312791 | Trevor Nguyen | Student in an Organized Health Care Education/Training Program | 17234 Valley Blvd, Building A, Fontana, CA 92335 | 2020-03-27 |
| 1184251365 | Benjamin Chang | Student in an Organized Health Care Education/Training Program | 17234 Valley Blvd., Bldg. A, Fontana, CA 92335 | 2020-03-26 |
| 1407487309 | Perla Hernandez | Licensed Vocational Nurse | 14677 Merrill Aver, Fontana, CA 92335 | 2020-01-29 |
| 1013552660 | Valencia Malone | Licensed Vocational Nurse | 14677 Merrill, Fontana, CA 92335 | 2019-11-07 |
| 1831749779 | Daniel Eric Wright | Student in an Organized Health Care Education/Training Program | 14677 Merrell Ave., Fontana, CA 92335 | 2019-09-12 |
| 1962069815 | Melissa Rivera | Licensed Vocational Nurse | 15217 San Bernardino Ave., Fontana, CA 92335 | 2019-05-28 |
| 1275199770 | Jennifer Lynn Malone | Peer Specialist | 14677 Merrall Ave, Fontana, CA 92335 | 2019-05-10 |
| 1770147894 | Noelle Chong | Registered Nurse | 14677 Merill Ave, Fontana, CA 92335 | 2019-04-24 |
| 1992261929 | Destiny Alzate | Counselor | 1467 Merrill Ave, Fontana, CA 92335 | 2019-02-14 |
| Find all providers in zip 92335 | ||||
| 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 |
|---|---|---|---|---|
| 1598179145 | Arj Medical, Inc. | Non-Pharmacy Dispensing Site | 8832 Sierra Ave, Fontana, CA 92335-8649 | 2014-06-11 |
| 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.