Molecular Imaging Corporation

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

License

B19999013291 Issued in CA

Legal business name

MOLECULAR IMAGING CORPORATION

Practice address

9530 Towne Centre Dr
Suite 120
San Diego, CA 92121-1981

Phone

(858) 642-0032

Fax

(858) 642-0052

NPI assigned

May 5, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Kenneth C Frederick

Title

Ceo

Phone

(858) 642-0032

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1146787200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1693958400000",
    "number": "1083662522",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9530 TOWNE CENTRE DR",
            "address_2": "SUITE 120",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921211981",
            "telephone_number": "858-642-0032",
            "fax_number": "858-642-0052"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9530 TOWNE CENTRE DR",
            "address_2": "SUITE 120",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921211981",
            "telephone_number": "858-642-0032",
            "fax_number": "858-642-0052"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOLECULAR IMAGING CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-05",
        "last_updated": "2023-09-06",
        "status": "A",
        "authorized_official_last_name": "FREDERICK",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "858-642-0032",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "CA",
            "license": "B19999013291",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kaveh Mokhtari
• Candice Badri Molavi
• Daniel P Molden, M.D.
• C. Craig Moldenhauer, M.D.
• Matthew Moldenhauer
• Molecular Imaging Sorrento Valley, LLC
• John Paul Molenaar, MA, F-AAA
• Rene John Molenkamp, LPCC
• Darcy Denise Molett
• Sophia Karan Molina Martinez

• Clinic/Center in San Diego, CA
• Providers in San Diego, CA by specialty
• Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2023; 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.