Providence Medical Foundation
Providence Medical Foundation is a healthcare organization registered as Surgery Physician in Eureka, CA, holding Type 2 (organization) NPI 1477790517 since 2009. The authorized official on file is Donald Anderson, Assistant Secretary of Enrollments.
✓ Active NPI ✓ Valid NPI checksum
| NPI | 1477790517 |
|---|---|
| Entity type | Organization (Type 2) |
| Legal business name | Providence Medical Foundation |
| Other name | <Unavail> |
| Practice address | 2752 HARRISON AVE, SUITE A, Eureka, CA, 95501 |
| Phone | 7072680190 |
| Enumeration date | 2009-01-12 |
| Last updated in NPPES | 2026-02-03 |
Authorized official
| Name | Donald Anderson |
|---|---|
| Title | Assistant Secretary of Enrollments |
| Phone | 4253589786 |
Taxonomy & classification
| Taxonomy code | Specialty | Primary | License | State |
|---|---|---|---|---|
| 208600000X | Surgery Physician | Primary | — | — |
Copy-ready billing details
Provider: Providence Medical Foundation NPI: 1477790517 Taxonomy: 208600000X (Surgery Physician) Address: 2752 HARRISON AVE, SUITE A, Eureka, CA, 95501
Providers at this address
| NPI | Name | Type | Specialty | Location |
|---|---|---|---|---|
| 1801806708 | Jon Omey | Individual | General Practice Dentistry | Eureka, CA |
| 1407930209 | Mark Pardoe | Individual | Plastic Surgery Physician | Eureka, CA |
| 1609948603 | Northcoast Neurosurgical Associates A Medical Corporation | Organization | Neurological Surgery Physician | Eureka, CA |
| 1578616686 | John Aryanpur | Individual | Neurological Surgery Physician | Eureka, CA |
| 1992918551 | Russel Pardoe, M.D., Inc. | Organization | Specialist | Eureka, CA |
| 1174731004 | Stephen Dieker | Individual | Anesthesiology Physician | Eureka, CA |
Verify this record
Cross-check NPI 1477790517 against the authoritative CMS record: view Providence Medical Foundation on the official NPPES registry .
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes — even if the provider moves or changes specialty. Read the full guide or validate an NPI number.
Frequently asked questions
What type of organization is Providence Medical Foundation?
What is a Type 2 NPI?
Source: CMS NPPES (public data). Snapshot 2026-07-11. Provider record last updated 2026-02-03.