1134295751 NPI number — DR. MARIA MOLINA MD

Table of content: DR. MARIA MOLINA MD (NPI 1134295751)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1134295751 NPI number — DR. MARIA MOLINA MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MOLINA
Provider First Name:
MARIA
Provider Middle Name:
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1134295751
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 500
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WEST FALMOUTH
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
02574
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
508-821-7731
Provider Business Mailing Address Fax Number:
508-821-4688

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2007 BAY STREET
Provider Second Line Business Practice Location Address:
SUITE 104
Provider Business Practice Location Address City Name:
TAUNTON
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
02780
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
508-821-7731
Provider Business Practice Location Address Fax Number:
508-821-4688
Provider Enumeration Date:
11/27/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207V00000X , with the licence number:  79046 , registered in the state of MA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 130171 . This is a "HARVARD PILGRIM" identifier . This identifiers is of the category "OTHER".
  • Identifier: 0701177 . This is a "UNITED HEALTH CARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 403341 . This is a "BLUE CHIP COORDINATED PAR" identifier . This identifiers is of the category "OTHER".
  • Identifier: 434260 . This is a "PHCS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 7419225684 . This is a "TRICARE CHAMPUS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 0081094 . This is a "HEALTH START PROGRAM MA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 2291716 . This is a "GROUP AETNA USHC HMO" identifier . This identifiers is of the category "OTHER".
  • Identifier: 3133885 , issued by the state of ( MA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 000000026438 . This is a "BMC HEALTHNET PLAN" identifier . This identifiers is of the category "OTHER".
  • Identifier: 2188373 . This is a "AETNA USHC HMO" identifier . This identifiers is of the category "OTHER".
  • Identifier: 5946A93 . This is a "AETNA USHC NON HMO" identifier . This identifiers is of the category "OTHER".
  • Identifier: J30928 . This is a "BCBS OF MA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 079046 . This is a "TUFTS HEALTH PLAN" identifier . This identifiers is of the category "OTHER".
  • Identifier: M17398 . This is a "GROUP BCBS OF MA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 20619 . This is a "BCBS OF RI" identifier . This identifiers is of the category "OTHER".
  • Identifier: 490630 . This is a "CIGNA HEALTH CARE" identifier . This identifiers is of the category "OTHER".




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