JOSEPH M MOLINA MD PROFESSIONAL CORPORATION SOUTHERN CALIFORNIA (NPI# 1699153858) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1699153858 |
| Entity Type | Organization |
| Organization Name | JOSEPH M MOLINA MD PROFESSIONAL CORPORATION SOUTHERN CALIFORNIA |
| Other Organization Name | MOLINA SOUTH SACRAMENTO MACK ROAD |
| Practice Address |
6339 Mack Rd Sacramento CA 95823-4655 |
| Mailing Address |
5626 Oberlin Dr Suite 110 San Diego CA 92121-1705 |
| Practice Telephone | 9165857912 |
| Enumeration Date | 2015-05-08 |
| Last Update Date | 2015-05-08 |
| Authorized Official Name | KENNY HEINE (VP OF OPERATIONS) |
| Authorized Official Telephone | 8589641506 |
| Is Organization Subpart | Y |
| Parent Organization Name | MEDVANTX, INC. |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 332900000X | Non-Pharmacy Dispensing Site | 20882 | CA | Suppliers |
| Other Name | Type Code |
|---|---|
| Molina South Sacramento Mack Road | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265836738 | Joseph M Molina Md Professional Corporation Southern California | Non-Pharmacy Dispensing Site | 1627 E Anaheim St, Long Beach, CA 90813-3809 | 2014-10-13 |
| 1336527597 | Joseph M Molina Md Professional Corporation Southern California | Non-Pharmacy Dispensing Site | 3234 Marysville Blvd, Sacramento, CA 95815-1411 | 2015-05-08 |
| 1154709301 | Joseph M Molina Md Professional Corporation Southern California | Non-Pharmacy Dispensing Site | 7777 Sunrise Blvd, Suite 2500, Citrus Heights, CA 95610-2300 | 2015-05-08 |
| 1881072049 | Joseph M Molina Md Professional Corporation Southern California | Non-Pharmacy Dispensing Site | 3946 Norwood Ave, Sacramento, CA 95838-3300 | 2015-05-08 |
| 1720465206 | Joseph M Molina Md Professional Corporation Southern California | Non-Pharmacy Dispensing Site | 190 E Highland Ave, San Bernardino, CA 92404-3658 | 2015-05-04 |
| 1538546015 | Joseph M Molina Md Professional Corporation Southern California | Non-Pharmacy Dispensing Site | 1181 N Mount Vernon Ave, Colton, CA 92324-2574 | 2015-05-04 |
| 1134506769 | Joseph M Molina Md Professional Corporation Southern California | Non-Pharmacy Dispensing Site | 14544 7th St, Victorville, CA 92395-4214 | 2015-05-04 |
| 1184001661 | Joseph M Molina Md Professional Corporation Southern California | Non-Pharmacy Dispensing Site | 5549 Van Buren Blvd, Riverside, CA 92503-2068 | 2015-05-04 |
| 1164809794 | Joseph M Molina Md Professional Corporation Southern California | Non-Pharmacy Dispensing Site | 24853 Alessandro Blvd, Suite 4, Moreno Valley, CA 92553-6102 | 2015-05-04 |
| 1124405758 | Joseph M Molina Md Professional Corporation Southern California | Non-Pharmacy Dispensing Site | 790 E Foothill Blvd, Rialto, CA 92376-5269 | 2015-05-04 |
| 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 |
| 1316339930 | Suzarie Van Spence | Nurse Practitioner | 6339 Mack Rd, Sacramento, CA 95823-4655 | 2015-02-19 |
| 1417360686 | Joseph M Molina Md Professional Corporation-southern California | Pediatrics | 6339 Mack Rd, Sacramento, CA 95823-4655 | 2014-06-05 |
| 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 | 332900000X |
| Grouping | Suppliers |
| Classification | Non-Pharmacy Dispensing Site |
| A site other than a pharmacy that dispenses medicinal preparations under the supervision of a physician to patients for self-administration. (e.g. physician offices, ER, Urgent Care Centers, Rural Health Facilities, etc.) |
| Notes: Source: Developed by National Council for Prescription Drug Programs (NCPDP), National Home Infusion Association (NHIA), and Pharmacist Services Technical Advisory Coalition (PSTAC) [1/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982088365 | Center for Interventional Spine, A Medical Corporation | Non-Pharmacy Dispensing Site | 1817 Professional Drive, Sacramento, CA 95825 | 2015-07-15 |
| 1336527597 | Joseph M Molina Md Professional Corporation Southern California | Non-Pharmacy Dispensing Site | 3234 Marysville Blvd, Sacramento, CA 95815-1411 | 2015-05-08 |
| 1881072049 | Joseph M Molina Md Professional Corporation Southern California | Non-Pharmacy Dispensing Site | 3946 Norwood Ave, Sacramento, CA 95838-3300 | 2015-05-08 |
| 1043612732 | Alok Krishna Md | Non-Pharmacy Dispensing Site | 87 Scripps Dr, Suite 210, Sacramento, CA 95825-6372 | 2014-09-24 |
| 1578965315 | Joseph M Molina Md Professional Corporation Southern California | Non-Pharmacy Dispensing Site | 7215 55th St, Sacramento, CA 95823-2601 | 2014-09-24 |
| 1295145670 | Dawei Zheng Md A Professional Medical Corp | Non-Pharmacy Dispensing Site | 8701 Center Pkwy, Suite 170, Sacramento, CA 95823-7918 | 2014-05-06 |
| 1851718175 | Tri-dung G Hoang Md Incorporated | Non-Pharmacy Dispensing Site | 6540 Stockton Blvd, Suite 3a, Sacramento, CA 95823-1635 | 2014-03-25 |
| 1962823781 | Associated Family Physicians Inc | Non-Pharmacy Dispensing Site | 8110 Timberlake Way, Sacramento, CA 95823-5401 | 2013-12-20 |
| 1356516108 | Mercy Medical Group, Inc. | Non-Pharmacy Dispensing Site | 3160 Folsom Blvd, 1st Flr, Sacramento, CA 95816-5219 | 2008-04-23 |
| 1679788020 | Molina Healthcare of California | Non-Pharmacy Dispensing Site | Molina Medical Centers - Smo, 7215 55th Street, Sacramento, CA 95823-2601 | 2007-05-11 |
| 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.