Joseph M Molina MD Professional Corporation-Southern California

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

JOSEPH M MOLINA MD PROFESSIONAL CORPORATION-SOUTHERN CALIFORNIA

Practice address

3322 Broadway
Suite 200
Everett, WA 98201-4425

Phone

(425) 249-4922

Fax

(877) 860-2284

NPI assigned

Jan 27, 2012

Reactivated

Mar 28, 2014

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

Vice President, Clinic Operations

Phone

(562) 491-7053

Specialties & licenses 2

Addresses

Other names 1

• Molina Medical Group of Southern California Doing business as

Locations

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

{
    "created_epoch": "1327622400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1395964800000",
    "number": "1073885786",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 OCEANGATE",
            "address_2": "SUITE 100",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908024317",
            "telephone_number": "562-499-6191",
            "fax_number": "562-499-6171"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3322 BROADWAY",
            "address_2": "SUITE 200",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982014425",
            "telephone_number": "425-249-4922",
            "fax_number": "877-860-2284"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOSEPH M MOLINA MD PROFESSIONAL CORPORATION-SOUTHERN CALIFORNIA",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-01-27",
        "last_updated": "2014-03-28",
        "deactivation_date": "2013-11-05",
        "reactivation_date": "2014-03-28",
        "status": "A",
        "authorized_official_last_name": "CALDERON",
        "authorized_official_first_name": "GLORIA",
        "authorized_official_title_or_position": "VICE PRESIDENT, CLINIC OPERATIONS",
        "authorized_official_telephone_number": "562-491-7053"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "WA",
            "license": null,
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Molina Medical Group of Southern California",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Carolyn Rose Jordon
• Genevieve Jorgensen
• Anjanette E Jorstad, MSW
• Annalie June Jose
• Julin Jose, RN
• Joseph M Molina MD Professional Corporation-Southern California
• Joseph Madson DMD PLLC
• Heena Narayan Joshi, MD
• Shilpa Joshi, DDS
• Darien Jourdaine, DO

• Family Medicine Physician in Everett, WA
• Providers in Everett, WA by specialty
• Family Medicine Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2014; 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.