Joseph M Molina MD Professional Corporation-Southern California

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

JOSEPH M MOLINA MD PROFESSIONAL CORPORATION-SOUTHERN CALIFORNIA

Practice address

6339 Mack Rd
Sacramento, CA 95823-4655

Phone

(916) 585-7912

Fax

(877) 479-7101

NPI assigned

Jun 5, 2014

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

President, Afc

Phone

(626) 346-2455

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Golden Shore Medical Group Other name

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

{
    "created_epoch": "1401926400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1517961600000",
    "number": "1417360686",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "625 FAIR OAKS AVE STE 270",
            "city": "SOUTH PASADENA",
            "state": "CA",
            "postal_code": "910305801",
            "telephone_number": "626-346-2455",
            "fax_number": "626-639-3005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6339 MACK RD",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958234655",
            "telephone_number": "916-585-7912",
            "fax_number": "877-479-7101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOSEPH M MOLINA MD PROFESSIONAL CORPORATION-SOUTHERN CALIFORNIA",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-06-05",
        "last_updated": "2018-02-07",
        "status": "A",
        "authorized_official_last_name": "CALDERON",
        "authorized_official_first_name": "GLORIA",
        "authorized_official_title_or_position": "PRESIDENT, AFC",
        "authorized_official_telephone_number": "626-346-2455"
    },
    "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": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "EFFECTIVE 1/5/15",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Golden Shore Medical Group",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Joseph M Molina MD Professional Corporation Southern California
• Joseph M Molina MD Professional Corporation Southern California
• Joseph M Molina MD Professional Corporation-Southern California
• Joseph M Molina MD Professional Corporation-Southern California
• Joseph M Molina MD Professional Corporation-Southern California
• Joseph M Young MD Inc
• Andrew Joseph III, MD
• Cecilia Joseph, MSW, ASW
• Jill Joseph, M.D.
• Melissa Joseph

• All providers in Sacramento, CA
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2018; 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.