PROVIDENCE MEDICAL FOUNDATION

SANTA ROSA, CA
NPI1265015978
Other NamePROVIDENCE MEDICAL GROUP NORTHERN CALIFORNIA
Entity TypeOrganization
Authorized ContactDONALD W. ANDERSON
Assistant Secretary Of Enrollments
425-358-9786
Organization Subpart ?No
Primary Taxonomy207Q00000X Family Medicine
Enumeration Date2021-04-30
Last Update Date2026-01-06
Business Address
PROVIDENCE MEDICAL FOUNDATION
185 SOTOYOME ST
SANTA ROSA, CA 95405-4803
Phone number: 707-303-8355
Mailing Address
PROVIDENCE MEDICAL FOUNDATION
PO BOX 31001 - 1920
PASADENA, CA 91110-1920
Phone number: 707-303-8355