Molina Medical Group Of Southern Ca | |
1714 St. Michaels Drive Suite #1 Santa Fe NM 87505-6059 | |
(505) 629-7585 | |
(562) 499-6171 |
Full Name | Molina Medical Group Of Southern Ca |
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Speciality | Family Medicine |
Location | 1714 St. Michaels Drive, Santa Fe, New Mexico |
Authorized Official Name and Position | Gloria Calderon (PRESIDENT AFC) |
Authorized Official Contact | 5624917053 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Molina Medical Group Of Southern Ca 100 Oceangate Suite 100 Long Beach CA 90802-4317 Ph: (562) 499-6191 | Molina Medical Group Of Southern Ca 1714 St. Michaels Drive Suite #1 Santa Fe NM 87505-6059 Ph: (505) 629-7585 |
NPI Number | 1215203385 |
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Provider Enumeration Date | 03/22/2012 |
Last Update Date | 03/22/2012 |
Identifier | Type | State | Issuer |
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1215203385 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Primary |
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