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

1151 E Walnut St
Ontario, CA 91761-6155

Phone

(909) 467-0797

Fax

(877) 778-8097

NPI assigned

Jan 27, 2012

Last updated

Feb 7, 2018By the provider in NPPES

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

Vice President, Clinic Operations

Phone

(626) 346-2455

Specialties & licenses 2

Addresses

Other identifiers 3

Other names 1

• Golden Shore Medical Group Other name

Locations

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

{
    "created_epoch": "1327622400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1517961600000",
    "number": "1568734267",
    "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": "1151 E WALNUT ST",
            "city": "ONTARIO",
            "state": "CA",
            "postal_code": "917616155",
            "telephone_number": "909-467-0797",
            "fax_number": "877-778-8097"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOSEPH M MOLINA MD PROFESSIONAL CORPORATION-SOUTHERN CALIFORNIA",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-01-27",
        "last_updated": "2018-02-07",
        "status": "A",
        "authorized_official_last_name": "CALDERON",
        "authorized_official_first_name": "GLORIA",
        "authorized_official_title_or_position": "VICE PRESIDENT, CLINIC OPERATIONS",
        "authorized_official_telephone_number": "626-346-2455"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": null,
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "APPROVED EFF:1/31/12",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDI-CAL",
            "identifier": "APPROVED EFF:1/31/12",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "DU4034-EFF. 3/10/12",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Golden Shore Medical Group",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Tracy Jones
• Valencia Brown Jones
• Jose Ruben Ramirez Professional Dental Corporation
• Joseph M Molina MD Professional Corporation - Southern California (Golden Shore Medical Group)
• Joseph M Molina MD Professional Corporation Southern California (Molina Ontario)
• Joelynne Joseph
• Melissa Gonzalez Joseph
• Laina Josiah
• Patjra Jotikasthira
• Tom Ten Jou, DDS

• Family Medicine Physician in Ontario, CA
• Providers in Ontario, 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 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.