Provider Demographics
NPI:1629417613
Name:MOLINA, ALORAH MICHELLE
Entity Type:Individual
Prefix:
First Name:ALORAH
Middle Name:MICHELLE
Last Name:MOLINA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ALORAH
Other - Middle Name:MOLINA
Other - Last Name:THOMAS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3806 FAIRMOUNT AVE
Mailing Address - Street 2:APT #223
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92105-2600
Mailing Address - Country:US
Mailing Address - Phone:224-280-0750
Mailing Address - Fax:
Practice Address - Street 1:NAVAL BRANCH MEDICAL CLINIC
Practice Address - Street 2:1ST AVE
Practice Address - City:PORT HUENEME
Practice Address - State:CA
Practice Address - Zip Code:93043-0001
Practice Address - Country:US
Practice Address - Phone:805-989-8030
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-06-23
Last Update Date:2013-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1710I1002XOther Service ProvidersMilitary Health Care ProviderIndependent Duty Corpsman