NPIMap

Organization Active NPI

Molina Healthcare of California

  • Family Medicine Physician
  • Sacramento, CA
National Provider Identifier
1841305075
Registry record updated Jan 14, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
MOLINA HEALTHCARE OF CALIFORNIA
Practice address
3234 Marysville Blvd
Sacramento, CA 95815-1411
Phone
(916) 646-1200
Fax
(916) 646-3385
NPI assigned
Aug 20, 2006
Last updated
Jan 14, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 14, 2011

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

Authorized official

Name
Gloria Calderon
Title
VP Clinic Operations
Phone
(888) 562-5442

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X Primary

Addresses

Primary practice location

3234 Marysville Blvd
Sacramento, CA 95815-1411

Mailing address

200 Oceangate Ste 100
Molina Medical Centers
Long Beach, CA 90802-4317
Phone (562) 499-6191

Other identifiers 1

IdentifierTypeStateIssuer
GR004265HMedicaidCA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 62

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 62

NPI Registry JSON

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

{
    "created_epoch": "1156032000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1294963200000",
    "number": "1841305075",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 OCEANGATE STE 100",
            "address_2": "MOLINA MEDICAL CENTERS",
            "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": "3234 MARYSVILLE BLVD",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958151411",
            "telephone_number": "916-646-1200",
            "fax_number": "916-646-3385"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOLINA HEALTHCARE OF CALIFORNIA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-20",
        "last_updated": "2011-01-14",
        "status": "A",
        "authorized_official_last_name": "CALDERON",
        "authorized_official_first_name": "GLORIA",
        "authorized_official_title_or_position": "VP CLINIC OPERATIONS",
        "authorized_official_telephone_number": "888-562-5442"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR004265H",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sacramento, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2011; 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.