St Joseph Heritage Healthcare

LBN: Providence Medical Foundation
St Joseph Heritage Healthcare is an health care organization with primary practice located at 200 W Center Street Promenade Ste 100 , Anaheim CA 92805-3960. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as the primary health care specialty. Providence Medical Foundation can be contacted via phone (714) 449-4841, or through Duplechan, Jill A via phone (714) 347-7790.

Contact Information

Primary practice address
200 W Center Street Promenade Ste 100 Anaheim CA 92805-3960
Phone: (714) 449-4841
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Duplechan, Jill A
Phone: (714) 347-7790

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X

Profile Details

NPI number 1609925957
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 Jan 9th, 2007
Last updated Sep 27th, 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 1609925957 NPPES
California MEDICAID GR0085350
California MEDICAID GR0085353
California MEDICAID GR0085351

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