NPIMap

Organization Active NPI

Joseph M Molina MD Professional Corporation-Southern California Molina

Doing business as Molina Medical Group of Southern CA

  • Family Medicine Physician
  • Santa Fe, NM
National Provider Identifier
1215203385
Registry record updated Mar 22, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
JOSEPH M MOLINA MD PROFESSIONAL CORPORATION-SOUTHERN CALIFORNIA MOLINA
Doing business as
Molina Medical Group of Southern CA
Practice address
1714 St. Michaels Drive
Suite #1
Santa Fe, NM 87505-6059
Phone
(505) 629-7585
Fax
(562) 499-6171
NPI assigned
Mar 22, 2012
Last updated
Mar 22, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 22, 2012

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

Authorized official

Name
Gloria Calderon
Title
President Afc
Phone
(562) 491-7053

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X Primary

Addresses

Primary practice location

1714 St. Michaels Drive
Suite #1
Santa Fe, NM 87505-6059

Mailing address

100 Oceangate
Suite 100
Long Beach, CA 90802-4317
Phone (562) 499-6191

Other names 1

  • Molina Medical Group of Southern CA 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

Other organizations with this tax ID 24

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

View all 24

Locations

1714 Saint Michaels Dr
Ste 1
Santa Fe, NM 87505
Phone (505) 629-7585

NPI Registry JSON

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

{
    "created_epoch": "1332374400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1332374400000",
    "number": "1215203385",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 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": "1714 ST. MICHAELS DRIVE",
            "address_2": "SUITE #1",
            "city": "SANTA FE",
            "state": "NM",
            "postal_code": "875056059",
            "telephone_number": "505-629-7585",
            "fax_number": "562-499-6171"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOSEPH M MOLINA MD PROFESSIONAL CORPORATION-SOUTHERN CALIFORNIA MOLINA",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-03-22",
        "last_updated": "2012-03-22",
        "status": "A",
        "authorized_official_last_name": "CALDERON",
        "authorized_official_first_name": "GLORIA",
        "authorized_official_title_or_position": "PRESIDENT AFC",
        "authorized_official_telephone_number": "562-491-7053"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Molina Medical Group of Southern CA",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Santa Fe, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2012; 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.