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

1181 N Mount Vernon Ave
Colton, CA 92324-2574

Phone

(909) 498-2356

Fax

(877) 824-9080

NPI assigned

Oct 19, 2012

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 2

Other names 1

• Molina Medical Group of Southern CA Doing business as

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

{
    "created_epoch": "1350604800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1401667200000",
    "number": "1780937334",
    "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": "908024302",
            "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": "1181 N MOUNT VERNON AVE",
            "city": "COLTON",
            "state": "CA",
            "postal_code": "923242574",
            "telephone_number": "909-498-2356",
            "fax_number": "877-824-9080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOSEPH M MOLINA MD PROFESSIONAL CORPORATION - SOUTHERN CALIFORNIA",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-10-19",
        "last_updated": "2014-06-02",
        "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": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "EFFECTIVE 10/21/13",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "DU5182-EFF 8/5/13",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Molina Medical Group of Southern CA",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Alexandra Jones
• Danielle Nicole Jones, LPN
• Joscelyn Marie Jones, BCBA
• Lakesha E Jones, NP
• Mohammad Jonny, MD
• Joseph M Molina MD Professional Corporation Southern California
• JP Express Laboratory Incorporated
• JP Express Laboratory, Inc
• Arline Juarez
• Irvin Omar Juarez

• Family Medicine Physician in Colton, CA
• Providers in Colton, 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 Jun 2, 2014; 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.