JOSEPH M MOLINA MD PROFESSIONAL CORPORATION-SOUTHERN CALIFORNIA (NPI# 1972875680) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1972875680 |
| Entity Type | Organization |
| Organization Name | JOSEPH M MOLINA MD PROFESSIONAL CORPORATION-SOUTHERN CALIFORNIA |
| Other Organization Name | GOLDEN SHORE MEDICAL GROUP |
| Practice Address |
190 E Highland Ave San Bernardino CA 92404-3658 |
| Mailing Address |
625 Fair Oaks Ave Ste 270 South Pasadena CA 91030-5801 |
| Practice Telephone | 9098824788 |
| Practice Fax Number | 8777789424 |
| Mailing Telephone | 6263462455 |
| Mailing Fax Number | 6266393005 |
| Enumeration Date | 2012-01-27 |
| Last Update Date | 2018-02-07 |
| Authorized Official Name | GLORIA CALDERON (VICE PRESIDENT, CLINIC OPERATIONS) |
| Authorized Official Telephone | 6263462455 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 208000000X | Pediatrics | CA | Allopathic & Osteopathic Physicians | |
| Y | 207Q00000X | Family Medicine | CA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | APPROVED EFF 1/31/12 | 05 | |
| CA | RAILROAD MEDICARE | DU4034-EFF 3/11/12 | 01 |
| Other Name | Type Code |
|---|---|
| Golden Shore Medical Group | Other Name - Individual/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 |
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 |
| 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 |
| 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 | 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 |
|---|---|---|---|---|
| 1346803954 | Community Health Care Foundation | Family Medicine | 406 E Vanderbilt Way Bldg 8, San Bernardino, CA 92408-3552 | 2019-04-18 |
| 1558837153 | Inland Empire Health Centers | Family Medicine | 1374 N Waterman Ave, San Bernardino, CA 92404-5313 | 2018-10-22 |
| 1356846281 | Maria Socorro Ruiz-rodriguez | Family Medicine | 850 W Highland Ave Ste A, San Bernardino, CA 92405-3855 | 2018-03-23 |
| 1588041859 | Mai-linh Ngoc Tran | Family Medicine | 1455 3rd Ave, San Bernardino, CA 92408 | 2015-05-06 |
| 1932514239 | Sarah Kin | Family Medicine | 1499 E Highland Ave, San Bernardino, CA 92404-4611 | 2014-06-25 |
| 1689930570 | Healthy Baby & Me, A Medical Corporation | Family Medicine | 1666 Medical Center Dr Ste 3, San Bernardino, CA 92411-1257 | 2012-04-05 |
| 1649548462 | Ralph R. Vega M.d., Dabfp Inc | Family Medicine | 1666 N. Medical Center Dr, Suite 2, San Bernardino, CA 92411-1257 | 2011-12-07 |
| 1477860187 | Molina Healthcare of California | Family Medicine | 170 East Highland Ave, San Bernardino, CA 92404-3658 | 2010-09-02 |
| 1043441900 | Healthy Preferred Inc | Family Medicine | 475 S Arrowhead Ave, Ste D, San Bernardino, CA 92408-1347 | 2009-07-27 |
| 1568629889 | Tae Kyu Kim | Family Medicine | 275 W Hospitality Ln Ste 200, San Bernardino, CA 92408-3238 | 2008-05-22 |
| Find all providers in SAN BERNARDINO | ||||
| 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.