Mary Martha Molina, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

G69817 Issued in CA

Practice address

200 Oceangate Ste 100
Long Beach, CA 90802-4317

Phone

(562) 499-6191

Fax

(562) 499-6171

NPI assigned

Dec 10, 2008

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Mary Martha Bernadett Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1228867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1228867200000",
    "number": "1487899092",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1627 E ANAHEIM ST",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908133809",
            "telephone_number": "562-437-0373",
            "fax_number": "562-591-9646"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 OCEANGATE STE 100",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908024317",
            "telephone_number": "562-499-6191",
            "fax_number": "562-499-6171"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOLINA",
        "first_name": "MARY",
        "middle_name": "MARTHA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-12-10",
        "last_updated": "2008-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "G69817",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G698170",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARY",
            "last_name": "BERNADETT",
            "middle_name": "MARTHA",
            "credential": "M.D.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Nicol Guadalupe Molina Torres
• Ceasar Molina
• Evelyn Daniela Molina
• Joseph M Molina, M.D.
• Marlyn Cristina Molina
• Roger Molina
• Molino Pharmacy Inc
• Johana Mollinedo
• Rafat Momensafaii, REHS
• Linda R Mona, PH.D.

• Family Medicine Physician in Long Beach, CA
• Providers in Long Beach, 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 Dec 10, 2008; 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.