| Providence Medical Foundation | |
|
500 Doyle Park Dr Suite 303 Santa Rosa CA 95405-4558 | |
| (707) 303-8300 | |
| (707) 303-8301 |
| Full Name | Providence Medical Foundation |
|---|---|
| Speciality | Internal Medicine |
| Location | 500 Doyle Park Dr, Santa Rosa, 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 500 Doyle Park Dr Suite 303 Santa Rosa CA 95405-4558 Ph: (707) 303-8300 |
| NPI Number | 1740584473 |
|---|---|
| Provider Enumeration Date | 01/10/2011 |
| Last Update Date | 05/05/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1740584473 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
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Thomas M. Collins Chiropractic, Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1212 Farmers Ln, Suite 2, Santa Rosa, CA 95405 Phone: 707-566-7396 Fax: 707-566-7398 | |
Vanguard Performance Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2901 Cleveland Ave Ste 202, Santa Rosa, CA 95403 Phone: 707-968-1555 Fax: 844-426-0134 | |
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