Providence Medical Foundation
NPI #1285890624 in Diamond Bar, California
Provider Information
- NPI Number
- 1285890624
- Entity Type
- Organization
- Organization Name
- Providence Medical Foundation
- Primary Specialty
- General Practice
- Enumeration Date
- Aug 5, 2008
- Last Updated
- Feb 3, 2026
Practice Location
- Address
- 1514 VALLEY VISTA DR
- City
- Diamond Bar
- State
- California
- ZIP Code
- 91765-3929
- Phone
- (909) 860-1144
Authorized Official
- Name
- DONALD W. ANDERSON JR.
- Title
- ASSISTANT SECRETARY OF ENROLLMENTS
- Phone
- (425) 358-9786
Specialties & Taxonomy Codes
| Specialty |
|---|
| General Practice |
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