OrganizationActive
Providence Medical Foundation
NPI 1316243769 · Orthopaedic Surgery Physician · Fullerton, CA
Provider details
- NPI number
- 1316243769
- Entity type
- Organization
- Primary specialty
- Orthopaedic Surgery PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Donald Anderson, Assistant Secretary of Enrollments(425) 358-9786
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Suppliers
Profile Score
Detailed profile(86/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
15 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
2 documented practice locations
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
2141 N Harbor Blvd Ste 35000
Fullerton, CA 92835
Phone: (714) 626-8630
Fax: (714) 626-8659
Street-level locationGet directions
Mailing address
Po Box 31001 - 1920
Pasadena, CA 91110-1920
Other names (DBA / former)
- Former legal business name
- St Joseph Heritage Healthcare
- Former legal business name
- St Jude Hospital Yorba Linda
Additional practice locations (1)
- 2141 N Harbor BlvdSuite 35000Fullerton, CA 92835-3827Phone: (714) 626-8630Fax: (714) 626-8659
Registry dates
- Enumerated
- 2011-02-02
- Last updated
- 2026-02-03
- Certified
- 2026-02-03
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.