JOSEPH M MOLINA MD PROFESSIONAL CORPORATION - SOUTHERN CALIFORNIA (NPI# 1780937334) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1780937334 |
| Entity Type | Organization |
| Organization Name | JOSEPH M MOLINA MD PROFESSIONAL CORPORATION - SOUTHERN CALIFORNIA |
| Other Organization Name | MOLINA MEDICAL GROUP OF SOUTHERN CA |
| Practice Address |
1181 N Mount Vernon Ave Colton CA 92324-2574 |
| Mailing Address |
200 Oceangate Suite 100 Long Beach CA 90802-4302 |
| Practice Telephone | 9094982356 |
| Practice Fax Number | 8778249080 |
| Mailing Telephone | 5624996191 |
| Mailing Fax Number | 5624996171 |
| Enumeration Date | 2012-10-19 |
| Last Update Date | 2014-06-02 |
| Authorized Official Name | GLORIA CALDERON (VICE PRESIDENT, CLINIC OPERATIONS) |
| Authorized Official Telephone | 5624917053 |
| 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 | RAILROAD MEDICARE | DU5182-EFF 8/5/13 | 01 |
| CA | EFFECTIVE 10/21/13 | 05 |
| Other Name | Type Code |
|---|---|
| Molina Medical Group of Southern CA | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780005140 | Joseph M Molina Md Professional Corporation - Southern California | Pediatrics | 1409 S State St, Orem, UT 84097-7703 | 2014-01-02 |
| 1063842334 | Joseph M Molina Md Professional Corporation - Southern California | Pediatrics | 2196 West 3500 South, Suite C1, West Valley City, UT 84119-3463 | 2013-11-22 |
| 1710478177 | Joseph M Molina Md Professional Corporation - Southern California | Obstetrics & Gynecology | 1151 E Walnut St, Ontario, CA 91761 | 2018-05-22 |
| 1093130080 | Joseph M Molina Md Professional Corporation - Southern California | Pediatrics | 2683 Pacific Ave, Long Beach, CA 90806-2610 | 2014-02-27 |
| 1518300912 | Joseph M Molina Md Professional Corporation - Southern California | Pediatrics | 14544 7th St, Victorville, CA 92395-4214 | 2013-04-16 |
| Street Address |
1181 N MOUNT VERNON AVE |
| City | COLTON |
| State | CA |
| Zip Code | 92324-2574 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053340562 | Esther Y Lo | Nurse Practitioner | 1181 N Mount Vernon Ave, Colton, CA 92324-2574 | 2006-06-30 |
| 1053878405 | Southern California Emergency Medicine | Clinic/Center | 1181 N Mount Vernon Ave, Colton, CA 92324-2574 | 2019-02-21 |
| 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 |
| 1396758942 | Mariam S. Moghadam | Family Medicine | 1181 N Mount Vernon Ave, Colton, CA 92324-2574 | 2006-08-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134739949 | Ava Vascular | Radiology | 1281 W. C. Street, Suite 200, Colton, CA 92324 | 2020-08-06 |
| 1063042851 | Making A Difference Association, Inc. | Psychologist | 1430 E Cooley Drive, Ste 111, Colton, CA 92324 | 2020-01-21 |
| 1326685488 | Allstar Medical Respite and Recuperative Care | Case Management | 450 N Sperry Drive, Colton, CA 92324 | 2019-12-06 |
| 1558916379 | Garfield Beach Cvs LLC | Durable Medical Equipment & Medical Supplies | 1010 North Pepper Ave, Colton, CA 92324 | 2019-08-08 |
| 1326692633 | Kadi Lyn Pearce | Licensed Practical Nurse | 970 N. Latham St, Colton, CA 92324 | 2019-07-25 |
| 1184281966 | Steven Andrew Cardoza | Physician Assistant | Armc, 400 N. Pepper Ave, Colton, CA 92324 | 2019-05-28 |
| 1528540952 | Daniel Tochukwu Umah-mgborogwu | Physician Assistant | 400 N Pepper Ave, Ste 107, Coton, CA 92324 | 2018-09-01 |
| 1255826038 | Cal Med Vascular Center LLC | Clinic/Center | 1281 W C St, Colton, CA 92324 | 2018-06-25 |
| 1891288072 | A. Arroyo Lourenco Dds, Inc | Dentist | 827 W Valley Blvd., Colton, CA 92324 | 2018-06-12 |
| 1700396165 | Emily Covington | Registered Nurse | 1550 E. Washington St., Ste 101, Colton, CA 92324 | 2017-10-11 |
| Find all providers in zip 92324 | ||||
| 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 |
|---|---|---|---|---|
| 1164063897 | Inland Empire Medical Group Inc. | Family Medicine | 1550 E Washington St # 101, Colton, CA 92324-4624 | 2019-10-03 |
| 1033473293 | Tawfikul Alam | Family Medicine | 400 N Pepper Ave Ste 204, Colton, CA 92324-1801 | 2012-07-02 |
| 1043504004 | Heather Bohn | Family Medicine | 400 N Pepper, Colton, CA 92324 | 2011-06-07 |
| 1477844017 | Brenda Lynn Rea | Family Medicine | 2112 Harris St, Colton, CA 92324-7523 | 2011-05-01 |
| 1528393535 | Ryan James Cabatbat | Family Medicine | 1699 E Washington St Apt 2016, Colton, CA 92324-4673 | 2009-10-08 |
| 1194992073 | Janette Marie Brunken | Family Medicine | 1981 Fig Tree Rd, Colton, CA 92324-8464 | 2008-05-10 |
| 1881805745 | Harpreet Singh | Family Medicine | 1300 East Cooley Drive, Colton, CA 92234-3905 | 2007-05-24 |
| 1871627307 | Sara Bigdeli | Family Medicine | 789 E Cooley Dr, Colton, CA 92324-4007 | 2007-03-15 |
| 1386793776 | Avera Mckennan | Family Medicine | 300 S. Sherman, Colton, SD 57018 | 2007-01-09 |
| 1114032448 | Molina Medical Centers | Family Medicine | 1001 E Cooley Dr Ste 106, Colton, CA 92324-3941 | 2006-08-19 |
| Find all providers in COLTON | ||||
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| 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.