Basic Information
| Provider Information | |||||||||
| NPI: | 1831773035 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MOLINA ROJAS | ||||||||
| FirstName: | LUIS | ||||||||
| MiddleName: | ORLANDO | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4077 INGLEWOOD BLVD APT 1 | ||||||||
| Address2: | |||||||||
| City: | LOS ANGELES | ||||||||
| State: | CA | ||||||||
| PostalCode: | 900665376 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4243011393 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1313 E HERNDON AVE STE 105 | ||||||||
| Address2: | |||||||||
| City: | FRESNO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 937203306 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5594504637 | ||||||||
| FaxNumber: | 5594501437 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/12/2021 | ||||||||
| LastUpdateDate: | 05/12/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 05/12/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 390200000X | Y | Student, Health Care | Student in an Organized Health Care Education/Training Program |
No ID Information.