Provider Demographics
NPI:1215433149
Name:MOLINA, CRIS JACOB (MD)
Entity type:Individual
Prefix:DR
First Name:CRIS
Middle Name:JACOB
Last Name:MOLINA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:CRIS
Other - Middle Name:R
Other - Last Name:MOLINA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:BDMC BMG HOSPITALISTS
Mailing Address - Street 2:1400 S DOBSON RD
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85202
Mailing Address - Country:US
Mailing Address - Phone:480-412-6788
Mailing Address - Fax:480-412-6848
Practice Address - Street 1:BDMC BMG HOSPITALISTS
Practice Address - Street 2:1400 S DOBSON RD
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85202
Practice Address - Country:US
Practice Address - Phone:480-412-6788
Practice Address - Fax:480-412-6848
Is Sole Proprietor?:No
Enumeration Date:2018-03-31
Last Update Date:2021-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ63127207R00000X, 207Q00000X, 208M00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program