| Molina Medical Group Of Southern California | |
|
2196 West 3500 South, Suite C1 West Valley City UT 84119-3463 | |
| (562) 499-6191 | |
| (562) 499-6171 |
| Full Name | Molina Medical Group Of Southern California |
|---|---|
| Speciality | Family Medicine |
| Location | 2196 West 3500 South, Suite C1, West Valley City, Utah |
| Authorized Official Name and Position | Gloria Calderon (VP, CLINIC OPERATIONS) |
| Authorized Official Contact | 5624996191 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Molina Medical Group Of Southern California 200 Oceangate Ste 100 Long Beach CA 90802-4317 Ph: (562) 499-6191 | Molina Medical Group Of Southern California 2196 West 3500 South, Suite C1 West Valley City UT 84119-3463 Ph: (562) 499-6191 |
| NPI Number | 1063842334 |
|---|---|
| Provider Enumeration Date | 11/22/2013 |
| Last Update Date | 05/27/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1063842334 | NPI | - | NPPES |
| EFF. 1/6/14 | Medicaid | UT |
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