| Joseph M Molina Md Professional Corporation-southern California | |
|
887 E. Second Street Pomona CA 91766-2009 | |
| (909) 620-7769 | |
| (877) 778-6944 |
| Full Name | Joseph M Molina Md Professional Corporation-southern California |
|---|---|
| Speciality | Family Medicine |
| Location | 887 E. Second Street, Pomona, California |
| Authorized Official Name and Position | Gloria Calderon (VICE PRESIDENT, CLINIC OPERATIONS) |
| Authorized Official Contact | 6263462455 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Joseph M Molina Md Professional Corporation-southern California 625 Fair Oaks Ave Ste 270 South Pasadena CA 91030-5801 Ph: (626) 346-2455 | Joseph M Molina Md Professional Corporation-southern California 887 E. Second Street Pomona CA 91766-2009 Ph: (909) 620-7769 |
| NPI Number | 1629340336 |
|---|---|
| Provider Enumeration Date | 01/27/2012 |
| Last Update Date | 02/07/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1629340336 | NPI | - | NPPES |
| APPROVED EFF 1/31/12 | Medicaid | CA | |
| DU4032-EFF. 6/7/12 | Other | CA | RAILROAD MEDICARE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (California) | Primary |
| 208000000X | Pediatrics | (California) | Secondary |
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California State Polytechnic University Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3801 W Temple Ave, Pomona, CA 91768 Phone: 909-869-4000 | |
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