PROVIDENCE MEDICAL FOUNDATION

APPLE VALLEY, CA
NPI1053616706
Former Legal Business NameST JOSEPH HERITAGE HEALTHCARE
Former Legal Business NameST JUDE HOSPITAL YORBA LINDA
Entity TypeOrganization
Authorized ContactDONALD W. ANDERSON
Assistant Secretary Of Enrollments
425-358-9786
Organization Subpart ?No
Primary Taxonomy208800000X Urology
Additional Taxonomies261QR0200X Clinic/Center, Radiology
332B00000X Durable Medical Equipment & Medical Supplies
Enumeration Date2011-01-11
Last Update Date2025-12-01
Business Address
PROVIDENCE MEDICAL FOUNDATION
19333 BEAR VALLEY RD SUITE 106
APPLE VALLEY, CA 92308-5148
Phone number: 760-240-5505
Mailing Address
PROVIDENCE MEDICAL FOUNDATION
PO BOX 31001 - 1920
PASADENA, CA 91110-1920
Phone number: 714-449-4800