| Molina Medical Group Of Southern California | |
|
1714 St. Michaels Drive #1 Santa Fe NM 87505-7617 | |
| (562) 499-6191 | |
| (562) 499-6171 |
| Full Name | Molina Medical Group Of Southern California |
|---|---|
| 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 |
|---|---|
| Molina Medical Group Of Southern California 100 Oceangate Suite 100 Long Beach CA 90802-4317 Ph: (562) 499-6191 | Molina Medical Group Of Southern California 1714 St. Michaels Drive #1 Santa Fe NM 87505-7617 Ph: (562) 499-6191 |
| NPI Number | 1649537051 |
|---|---|
| Provider Enumeration Date | 04/23/2012 |
| Last Update Date | 04/23/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1649537051 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
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