PROVIDENCE MEDICAL FOUNDATION NPI 1427305960

NPI Information

  • NPI: 1427305960
  • Provider Name: PROVIDENCE MEDICAL FOUNDATION
  • Classification: Family Medicine - 207Q00000X
  • Entity Type: Organization
  • Former Legal Business Name: ST JOSEPH HERITAGE HEALTHCARE
  • CLIA Number: 05D2029948
  • Address: 26522 LA ALAMEDA
    SUITE 120
    MISSION VIEJO, CA
    ZIP 92691
  • Phone: (949) 364-9631

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NPI Details

PROVIDENCE MEDICAL FOUNDATION is a family medicine in Mission Viejo, CA. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. PROVIDENCE MEDICAL FOUNDATION NPI is 1427305960. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Former Legal Business Name Is St Joseph Heritage Healthcare.

The provider's business location address is:

26522 LA ALAMEDA
SUITE 120
MISSION VIEJO, CA
ZIP 92691-330
Phone: (949) 364-9631

The provider's authorized official is Jill A Duplechan .
The authorized official title is Chief Administrative Officer and has the following contact phone number (714) 347-7790.

The CLIA number assigned to this NPI record is 05D2029948 - physician office with a certificate type of Certificate of Compliance.

The enumeration date for this NPI number is 8/14/2012 and was last updated on 5/5/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207Q00000XFamily MedicineYes
2208100000XPhysical Medicine & RehabilitationNo

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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