Molina Healthcare of California

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

MOLINA HEALTHCARE OF CALIFORNIA

Practice address

790 E. Foothill Blvd
Rialto, CA 92376

Phone

(909) 237-2438

Fax

(562) 499-6171

NPI assigned

Oct 25, 2010

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

VP Clinic Operations

Phone

(562) 499-6191

Specialties & licenses 2

Addresses

Locations

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

{
    "created_epoch": "1287964800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1316390400000",
    "number": "1376843334",
    "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": "790 E. FOOTHILL BLVD",
            "city": "RIALTO",
            "state": "CA",
            "postal_code": "92376",
            "telephone_number": "909-237-2438",
            "fax_number": "562-499-6171"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOLINA HEALTHCARE OF CALIFORNIA",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-10-25",
        "last_updated": "2011-09-19",
        "status": "A",
        "authorized_official_last_name": "CALDERON",
        "authorized_official_first_name": "GLORIA",
        "authorized_official_title_or_position": "VP CLINIC OPERATIONS",
        "authorized_official_telephone_number": "562-499-6191"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anabelle Miranda-Muniz, LMFT
• Marisa Miranda
• Sally Ann Mitchell
• MJ Senior Homecare Services LLC
• Anoud Mohammad
• Molina Healthcare of California
• Irish Nicole Monagan
• Moonstone Care Home LLC
• Amber Mona Mora, PHARMD
• Octaviano Mora, PHARM.D.

• Family Medicine Physician in Rialto, CA
• Providers in Rialto, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2011; 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.