Molina Medical Group of New Mexico, PC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

MOLINA MEDICAL GROUP OF NEW MEXICO, PC

Practice address

200 Oceangate Ste 100
Long Beach, CA 90802-4317

Phone

(562) 499-6191

NPI assigned

Oct 29, 2013

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Gloria Calderon

Title

VP, Clinic Operations

Phone

(562) 499-6191

Specialties & licenses 4

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1383004800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1383004800000",
    "number": "1033547146",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1714 SAINT MICHAELS DR # 1",
            "city": "SANTA FE",
            "state": "NM",
            "postal_code": "875057617",
            "telephone_number": "505-490-4042",
            "fax_number": "877-846-3680"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 OCEANGATE STE 100",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908024317",
            "telephone_number": "562-499-6191"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOLINA MEDICAL GROUP OF NEW MEXICO, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-10-29",
        "last_updated": "2013-10-29",
        "status": "A",
        "authorized_official_last_name": "CALDERON",
        "authorized_official_first_name": "GLORIA",
        "authorized_official_title_or_position": "VP, CLINIC OPERATIONS",
        "authorized_official_telephone_number": "562-499-6191"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "CA",
            "license": null,
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": "CA",
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Molina Healthcare of California
• Molina Healthcare of California
• Molina Healthcare of California Partner Plan, Inc.
• Molina Healthcare of Kentucky Inc.
• Molina Healthcare of Nebraska
• Nicol Guadalupe Molina Torres
• Ceasar Molina
• Evelyn Daniela Molina
• Joseph M Molina, M.D.
• Marlyn Cristina Molina

• Family Medicine Physician in Long Beach, CA
• Providers in Long Beach, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.