Molina Healthcare of California

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

MOLINA HEALTHCARE OF CALIFORNIA

Practice address

17500 Foothill Blvd Ste A2
Fontana, CA 92335-3798

Phone

(908) 428-0170

Fax

(877) 778-9312

NPI assigned

Aug 19, 2006

Organization subpart

No

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

Authorized official

Name

Matthew Schueren

Title

V.P. Finance

Phone

(888) 562-5442

Specialties & licenses 3

Addresses

Other identifiers 1

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

{
    "created_epoch": "1155945600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1512518400000",
    "number": "1689788085",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 OCEANGATE",
            "address_2": "#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": "17500 FOOTHILL BLVD STE A2",
            "city": "FONTANA",
            "state": "CA",
            "postal_code": "923353798",
            "telephone_number": "908-428-0170",
            "fax_number": "877-778-9312"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOLINA HEALTHCARE OF CALIFORNIA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-19",
        "last_updated": "2017-12-06",
        "status": "A",
        "authorized_official_last_name": "SCHUEREN",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_title_or_position": "V.P. FINANCE",
        "authorized_official_telephone_number": "888-562-5442"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR004265D",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mohammad Abul Fielat DDS Inc
• Namita P. Mohideen, M.D.
• Chaniia Leigh Mohorne
• Manuel Ricardo Mojica Jr., M.D.
• Farkhondeh Mokri-Arganeh, D.C.
• Bobby Lou Moll, MS, RD
• Arezo Momenzadeh
• Feyisayo M Momoh, LCSW
• Sally E. Monken, MD
• Vanessa Gail Montalbo

• Family Medicine Physician in Fontana, CA
• Providers in Fontana, 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 6, 2017; 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.