NPIMap

Organization Active NPI

Molina Medical Centers

  • Family Medicine Physician
  • Woodland, CA
National Provider Identifier
1083729206
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
MOLINA MEDICAL CENTERS
Practice address
3 Court St
Woodland, CA 95695-3111
Phone
(530) 668-9293
Fax
(530) 668-0231
NPI assigned
Aug 20, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dennis Wayne Evans
Title
Strategic Planner, Research and Dev
Phone
(562) 499-6191

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

3 Court St
Woodland, CA 95695-3111

Mailing address

One Golden Shore
Molina Medical Centers Smo
Long Beach, CA 90802-4202
Phone (562) 499-6191

National Provider Directory

National Provider Directory
Tax ID family
Molina Healthcare of California11 organizations share this tax ID, including this one

Other organizations with this tax ID 10

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

Locations

3 Court St
Woodland, CA 95695
Phone (530) 666-5551

NPI Registry JSON

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

{
    "created_epoch": "1156032000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1083729206",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "ONE GOLDEN SHORE",
            "address_2": "MOLINA MEDICAL CENTERS SMO",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908024202",
            "telephone_number": "562-499-6191"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 COURT ST",
            "city": "WOODLAND",
            "state": "CA",
            "postal_code": "956953111",
            "telephone_number": "530-668-9293",
            "fax_number": "530-668-0231"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOLINA MEDICAL CENTERS",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-20",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "EVANS",
        "authorized_official_first_name": "DENNIS",
        "authorized_official_middle_name": "WAYNE",
        "authorized_official_title_or_position": "STRATEGIC PLANNER, RESEARCH AND DEV",
        "authorized_official_telephone_number": "562-499-6191"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodland, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.