Provider Demographics
NPI:1952315848
Name:MOLINA, GEORGE C (MD)
Entity Type:Individual
Prefix:
First Name:GEORGE
Middle Name:C
Last Name:MOLINA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:685 MEDICAL CENTER DR W STE 102
Mailing Address - Street 2:
Mailing Address - City:CLOVIS
Mailing Address - State:CA
Mailing Address - Zip Code:93611-6804
Mailing Address - Country:US
Mailing Address - Phone:559-297-3333
Mailing Address - Fax:559-297-3344
Practice Address - Street 1:684 MEDICAL CENTER DR E STE 102
Practice Address - Street 2:
Practice Address - City:CLOVIS
Practice Address - State:CA
Practice Address - Zip Code:93611-6806
Practice Address - Country:US
Practice Address - Phone:559-297-3333
Practice Address - Fax:559-297-3344
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-28
Last Update Date:2023-08-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAOOG675930207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA05D0936928OtherCLIA
CAF26869Medicare UPIN
CA05D0936928OtherCLIA