JOSEPH M MOLINA MD PROFESSIONAL CORPORATION-SOUTHERN CALIFORNIA (NPI# 1417360686) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417360686 |
| Entity Type | Organization |
| Organization Name | JOSEPH M MOLINA MD PROFESSIONAL CORPORATION-SOUTHERN CALIFORNIA |
| Other Organization Name | GOLDEN SHORE MEDICAL GROUP |
| Practice Address |
6339 Mack Rd Sacramento CA 95823-4655 |
| Mailing Address |
625 Fair Oaks Ave Ste 270 South Pasadena CA 91030-5801 |
| Practice Telephone | 9165857912 |
| Practice Fax Number | 8774797101 |
| Mailing Telephone | 6263462455 |
| Mailing Fax Number | 6266393005 |
| Enumeration Date | 2014-06-05 |
| Last Update Date | 2018-02-07 |
| Authorized Official Name | GLORIA CALDERON (PRESIDENT, AFC) |
| Authorized Official Telephone | 6263462455 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 208000000X | Pediatrics | Allopathic & Osteopathic Physicians | ||
| Y | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | EFFECTIVE 1/5/15 | 05 |
| Other Name | Type Code |
|---|---|
| Golden Shore Medical Group | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558633255 | Joseph M Molina Md Professional Corporation-southern California | Pediatrics | 790 E Foothill Blvd, Suite D, Rialto, CA 92376-5269 | 2012-01-27 |
| 1982976692 | Joseph M Molina Md Professional Corporation-southern California | Internal Medicine | 445 E. Anaheim Street, #h, Wilmington, CA 90744-4600 | 2012-01-27 |
| 1588935233 | Joseph M Molina Md Professional Corporation-southern California | Pediatrics | 5549 Van Buren Blvd., Riverside, CA 92503-2068 | 2012-01-25 |
| 1124399860 | Joseph M Molina Md Professional Corporation-southern California | Pediatrics | 24853 Alessandro Blvd., #4, Moreno Valley, CA 92553-6102 | 2012-01-25 |
| 1215208962 | Joseph M Molina Md Professional Corporation-southern California | Pediatrics | 540 E. Artesia Boulevard, Long Beach, CA 90805-1476 | 2012-01-25 |
| 1801177944 | Joseph M Molina Md Professional Corporation-southern California | Pediatrics | 1714 Saint Michaels Dr, #1, Santa Fe, NM 87505-7617 | 2011-09-02 |
| 1508279779 | Joseph M Molina Md Professional Corporation-southern California | Pediatrics | 7777 Sunrise Blvd, Suite 2500, Citrus Heights, CA 95610-2300 | 2014-06-05 |
| 1235542408 | Joseph M Molina Md Professional Corporation-southern California | Pediatrics | 3946 Norwood Ave, Sacramento, CA 95838-3300 | 2014-06-05 |
| 1326451592 | Joseph M Molina Md Professional Corporation-southern California | Pediatrics | 3234 Marysville Blvd, Sacramento, CA 95815-1411 | 2014-06-05 |
| 1164835344 | Joseph M Molina Md Professional Corporation-southern California | Pediatrics | 7215 55th St, Sacramento, CA 95823-2601 | 2014-06-05 |
| Street Address |
6339 MACK RD |
| City | SACRAMENTO |
| State | CA |
| Zip Code | 95823-4655 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033243001 | Adrienne Eusebio Wolowodiuk | Social Worker | 6339 Mack Rd, Sacramento, CA 95823-4655 | 2007-03-14 |
| 1154947711 | Elica Health Centers | Clinic/Center | 6339 Mack Rd, Sacramento, CA 95823-4655 | 2020-06-19 |
| 1770098188 | Molina Healthcare of Californa | Internal Medicine | 6339 Mack Rd, Sacramento, CA 95823-4655 | 2017-12-07 |
| 1629527023 | Arbert Nazareno | Nurse Practitioner | 6339 Mack Rd, Sacramento, CA 95823-4655 | 2016-09-26 |
| 1699153858 | Joseph M Molina Md Professional Corporation Southern California | Non-Pharmacy Dispensing Site | 6339 Mack Rd, Sacramento, CA 95823-4655 | 2015-05-08 |
| 1316339930 | Suzarie Van Spence | Nurse Practitioner | 6339 Mack Rd, Sacramento, CA 95823-4655 | 2015-02-19 |
| 1871823237 | Kao Yang Lee | Physician Assistant | 6339 Mack Rd, Sacramento, CA 95823-4655 | 2010-01-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396343422 | Renee Yvonne Friesner | Registered Nurse | 6965 65th Street, Sacramento, CA 95823 | 2020-10-12 |
| 1790392165 | Amanda Moore | Technician | 6445 Village Center Dr, Building 7 Apt 101, Sacramento, CA 95823 | 2020-09-29 |
| 1114562766 | Daniel & Max, LLC | Optometrist | 4200 Florin Road, Suite C, Florin, CA 95823 | 2019-11-07 |
| 1396393823 | Lannon Hope Gustafson | Counselor | 8573 E Southgate Dr., Sacramento, CA 95823 | 2019-08-28 |
| 1932768280 | Sprenger Behavioral Medicine, Inc | Psychiatry & Neurology | 7601 Hospital Drive Suite 202, Suite 202, Sacramento, CA 95823 | 2019-06-11 |
| 1306316880 | Evin Johnson | Case Manager/Care Coordinator | 7000 Franklin Blvd Suite 625, Sacramento, CA 95823 | 2018-11-28 |
| 1902373095 | Alexandra L Bourcy | Family Medicine | 7275 E Southgate Dr Ste 204-206, Sacramento, CA 95823 | 2018-10-27 |
| 1891298923 | Nicholas Joseph Henderson | Behavior Technician | 6500 47th Street Apt#76, Sacramento, CA 95823 | 2018-03-15 |
| 1427567098 | Luz Maria Udave | Behavior Technician | 5435 Mack Rd Apt 87, Sacramento, CA 95823 | 2017-09-26 |
| 1417474743 | Elizabeth Smithers | Behavior Technician | 5545 Sky Parkway #202, Sacramento, CA 95823 | 2017-08-28 |
| Find all providers in zip 95823 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023638327 | Fast Medical Care LLC | Family Medicine | 342 Main Ave, Sacramento, CA 95838-2063 | 2020-04-16 |
| 1386275246 | Zsm Medical Services Inc | Family Medicine | 8 Cain Ct, Sacramento, CA 95834-1067 | 2020-01-30 |
| 1083265565 | Rajwinder Kaur | Family Medicine | 11 Poinsettia Ct, Sacramento, CA 95838-2282 | 2019-09-25 |
| 1629630314 | Archway Health Care Services Inc | Family Medicine | 8950 Cal Center Dr Ste 112, Sacramento, CA 95826-3236 | 2019-07-02 |
| 1902373095 | Alexandra L Bourcy | Family Medicine | 7275 E Southgate Dr Ste 204-206, Sacramento, CA 95823 | 2018-10-27 |
| 1487186334 | Emilie Dempsey | Family Medicine | 2801 27th St, Sacramento, CA 95818-3221 | 2017-03-30 |
| 1396198958 | River City Medical Group Inc | Family Medicine | 7311 Greenhaven Dr, Suite 145, Sacramento, CA 95831-3572 | 2016-07-19 |
| 1215382197 | Manpreet Kaur Gill | Family Medicine | 3308 El Camino Ave # 300-434, Sacramento, CA 95821-6327 | 2016-04-28 |
| 1457764235 | Sharndeep Kaur Bains | Family Medicine | 10470 Old Placerville Road, Ste 100, Sacramento, CA 95827-2539 | 2014-06-09 |
| 1346650306 | Queena Dai | Family Medicine | 1201 Alhambra Blvd Ste 230, Sacramento, CA 95816-5241 | 2014-04-30 |
| Find all providers in SACRAMENTO | ||||
| City | SACRAMENTO |
| Zip Code | 95823 |
Please comment or provide details below to improve the information on JOSEPH M MOLINA MD PROFESSIONAL CORPORATION-SOUTHERN CALIFORNIA.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.