NPIMap

Organization Active NPI

Joseph M Molina MD Professional Corporation Southern California

Doing business as Molina North Long Beach

  • Non-Pharmacy Dispensing Site
  • Long Beach, CA
National Provider Identifier
1083017834
Registry record updated Dec 3, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Non-Pharmacy Dispensing SiteTaxonomy code 332900000X
License
20A10903 Issued in CA
Legal business name
JOSEPH M MOLINA MD PROFESSIONAL CORPORATION SOUTHERN CALIFORNIA
Doing business as
Molina North Long Beach
Practice address
540 E Artesia Blvd
Long Beach, CA 90805-1476
Phone
(562) 423-3383
NPI assigned
Oct 7, 2014
Last updated
Dec 3, 2015By the provider in NPPES
Organization subpart
Yes
Parent organization
MEDVANTX INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 3, 2015

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

Authorized official

Name
Kenny Heine
Title
VP of Operations
Phone
(858) 964-1506

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Non-Pharmacy Dispensing Site 332900000X 20A10903 CA Primary

Addresses

Primary practice location

540 E Artesia Blvd
Long Beach, CA 90805-1476

Mailing address

9276 Scranton Rd
Suite 100
San Diego, CA 92121-7701

Other names 1

  • Molina North Long Beach Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Joseph M Molina MD Professional Corporation Southern California25 organizations share this tax ID, including this one
Part of
Medvantx Inc

Other organizations with this tax ID 24

Organizations that report the same tax identification number in the National Provider Directory.

View all 24

Locations

540 E Artesia Blvd
Long Beach, CA 90805
Phone (310) 423-3383

NPI Registry JSON

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

{
    "created_epoch": "1412640000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1449100800000",
    "number": "1083017834",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9276 SCRANTON RD",
            "address_2": "SUITE 100",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921217701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "540 E ARTESIA BLVD",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908051476",
            "telephone_number": "562-423-3383"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOSEPH M MOLINA MD PROFESSIONAL CORPORATION SOUTHERN CALIFORNIA",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MEDVANTX INC",
        "enumeration_date": "2014-10-07",
        "last_updated": "2015-12-03",
        "status": "A",
        "authorized_official_last_name": "HEINE",
        "authorized_official_first_name": "KENNY",
        "authorized_official_title_or_position": "VP OF OPERATIONS",
        "authorized_official_telephone_number": "858-964-1506"
    },
    "taxonomies": [
        {
            "code": "332900000X",
            "taxonomy_group": "",
            "desc": "Non-Pharmacy Dispensing Site",
            "state": "CA",
            "license": "20A10903",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Molina North Long Beach",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Long Beach, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2015; 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.