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Organization

PROVIDENCE MEDICAL FOUNDATION

Active
Other names
St Joseph Heritage Healthcare
Organization subpart
No

Provider details

NPI number
Authorized official
DONALD W. ANDERSON JR. (ASSISTANT SECRETARY OF ENROLLMENTS)
(425) 358-9786
Entity
Organization

Contact information

Practice address
1010 W LA VETA AVE STE 200, ORANGE, CA 92868-4301
(714) 835-1800
(714) 835-1811
Mailing address
PO BOX 31001 - 1920, PASADENA, CA 91110-1920
(714) 449-4800

Taxonomy

Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary

Other

Enumeration date
08/19/2019
Last updated
02/03/2026
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