Molina Medical Group of Michigan, PC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

MOLINA MEDICAL GROUP OF MICHIGAN, PC

Practice address

4700 Schaefer Rd
Dearborn, MI 48126-3655

Phone

(313) 581-2600

Fax

(313) 581-0228

NPI assigned

Jul 26, 2017

Organization subpart

No

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

Authorized official

Name

J Mario Molina, MD

Title

Owner

Phone

(562) 499-6191

Specialties & licenses 2

Addresses

Other names 2

• Avalon Health Center Doing business as
• Avalon Health Center-Urgent Care Other name

Locations

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

{
    "created_epoch": "1501027200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1497279020",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4700 SCHAEFER RD",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481263655",
            "telephone_number": "313-581-2600",
            "fax_number": "313-581-0228"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4700 SCHAEFER RD",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481263655",
            "telephone_number": "313-581-2600",
            "fax_number": "313-581-0228"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOLINA MEDICAL GROUP OF MICHIGAN, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-07-26",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "MOLINA",
        "authorized_official_first_name": "J",
        "authorized_official_middle_name": "MARIO",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "562-499-6191",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Avalon Health Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Avalon Health Center-Urgent Care",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Avalon Health Center-Urgent Care",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Nicole Mokanyk, LPTA
• Maya Mokh
• Nadine Mokh
• Molina Medical Group of Michigan, PC
• Molina Medical Group of Michigan, PC
• Angelina Christina Molinaro
• Hunter Molino
• Momba Home Care Michigan, LLC
• Momba Home Care Michigan, LLC
• Feroze A Momin, MD

• Internal Medicine Physician in Dearborn, MI
• Providers in Dearborn, MI by specialty
• Internal Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.