St Joseph Heritage Healthcare

LBN: Providence Medical Foundation
St Joseph Heritage Healthcare is an health care organization with primary practice located at 1514 Valley Vista Dr , Diamond Bar CA 91765-3929. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / General Practice, which is considered as the primary health care specialty. Providence Medical Foundation can be contacted via phone (909) 860-1144, or through Duplechan, Jill A via phone (714) 347-7790.

Contact Information

Primary practice address
1514 Valley Vista Dr Diamond Bar CA 91765-3929
Phone: (909) 860-1144
Fax: (909) 860-8307
Website:
Map and Directions
Authorized official contact:
Name: Duplechan, Jill A
Phone: (714) 347-7790

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / General Practice 208D00000X

Profile Details

NPI number 1285890624
LBN Legal business name Providence Medical Foundation
DBA Doing business as St Joseph Heritage Healthcare
Authorized official Duplechan, Jill A
Entity Organization
Organization subpart 1 No
Enumeration date Aug 5th, 2008
Last updated May 5th, 2021 - about 3 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1285890624 NPPES
California Other CG4895 RAILROAD MEDICARE PROVIDER NUMBER

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