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

Doing business as

Molina Medical Group of Southern California

Practice address

15 SW Everett Mall Way
Suite a
Everett, WA 98204-2715

Phone

(425) 348-6727

Fax

(877) 860-2991

NPI assigned

Jan 27, 2012

Last updated

Jun 18, 2013By 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

(562) 491-7053

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Molina Medical Group of Southern California Doing business as

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

{
    "created_epoch": "1327622400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1371513600000",
    "number": "1700158417",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 OCEANGATE",
            "address_2": "SUITE 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": "15 SW EVERETT MALL WAY",
            "address_2": "SUITE A",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982042715",
            "telephone_number": "425-348-6727",
            "fax_number": "877-860-2991"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOSEPH M MOLINA MD PROFESSIONAL CORPORATION-SOUTHERN CALIFORNIA",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-01-27",
        "last_updated": "2013-06-18",
        "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": "562-491-7053"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": null,
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WA",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "APPROVED/PROVIDERONE",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Molina Medical Group of Southern California",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Genevieve Jorgensen
• Anjanette E Jorstad, MSW
• Annalie June Jose
• Julin Jose, RN
• Joseph M Molina MD Professional Corporation-Southern California (Molina Medical Group of Southern California)
• Joseph Madson DMD PLLC
• Heena Narayan Joshi, MD
• Shilpa Joshi, DDS
• Darien Jourdaine, DO
• Brigette Ann Journeay, MSW

• Family Medicine Physician in Everett, WA
• Providers in Everett, WA by specialty
• Family Medicine Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2013; 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.