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 ContactJILL A DUPLECHAN
Chief Administrative Officer
714-347-7790
Organization Subpart ?No
Primary Taxonomy208800000X Urology
Additional Taxonomies332B00000X Durable Medical Equipment & Medical Supplies
Enumeration Date2011-01-11
Last Update Date2021-05-05
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
200 W CENTER STREET PROMENADE STE 300
ANAHEIM, CA 92805-3960
Phone number: 714-449-4800