Providence Medical Foundation | |
200 W Center Street Promenade Anaheim CA 92805-3960 | |
(147) 123-5007 | |
Not Available |
Full Name | Providence Medical Foundation |
---|---|
Speciality | Family Medicine |
Location | 200 W Center Street Promenade, Anaheim, California |
Authorized Official Name and Position | Jill A Duplechan (CHIEF ADMINISTRATIVE OFFICER) |
Authorized Official Contact | 7143477790 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Providence Medical Foundation 200 W Center Street Promenade Ste 300 Anaheim CA 92805-3960 Ph: (714) 449-4800 | Providence Medical Foundation 200 W Center Street Promenade Anaheim CA 92805-3960 Ph: (147) 123-5007 |
NPI Number | 1639715709 |
---|---|
Provider Enumeration Date | 11/22/2019 |
Last Update Date | 05/05/2021 |
Identifier | Type | State | Issuer |
---|---|---|---|
1639715709 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Primary |
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› Verified 9 days ago
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