Molina Healthcare Of California | |
190 E Highland Ave San Bernardino CA 92404-3658 | |
(909) 882-4788 | |
(877) 860-7268 |
Full Name | Molina Healthcare Of California |
---|---|
Speciality | Family Medicine |
Location | 190 E Highland Ave, San Bernardino, California |
Authorized Official Name and Position | Matthew Schueren (V.P. FINANCE) |
Authorized Official Contact | 8885625442 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Molina Healthcare Of California 200 Oceangate #100 Long Beach CA 90802-4317 Ph: (562) 499-6191 | Molina Healthcare Of California 190 E Highland Ave San Bernardino CA 92404-3658 Ph: (909) 882-4788 |
NPI Number | 1861507006 |
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Provider Enumeration Date | 08/20/2006 |
Last Update Date | 12/06/2017 |
Identifier | Type | State | Issuer |
---|---|---|---|
1861507006 | NPI | - | NPPES |
GR004265U | Medicaid | CA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (California) | Primary |
207R00000X | Internal Medicine | (* (Not Available)) | Secondary |
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