Provider Demographics
NPI:1932504461
Name:MANFRED MOLINA,MD INC.
Entity Type:Organization
Organization Name:MANFRED MOLINA,MD INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:
Authorized Official - First Name:MANFRED
Authorized Official - Middle Name:
Authorized Official - Last Name:MOLINA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:323-560-4373
Mailing Address - Street 1:4433 SLAUSON AVE
Mailing Address - Street 2:
Mailing Address - City:MAYWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:90270-2931
Mailing Address - Country:US
Mailing Address - Phone:323-560-4373
Mailing Address - Fax:323-560-2205
Practice Address - Street 1:4433 SLAUSON AVE
Practice Address - Street 2:
Practice Address - City:MAYWOOD
Practice Address - State:CA
Practice Address - Zip Code:90270-2931
Practice Address - Country:US
Practice Address - Phone:323-560-4373
Practice Address - Fax:323-560-2205
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-27
Last Update Date:2014-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty