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Providence Medical Foundation

Family Medicine Physician in Brea, CA · enumerated 2006 · authorized official Donald Anderson, Assistant Secretary of Enrollments.

Data current as of Jul 13, 2026 · sourced from CMS NPPES

National Provider Identifier

1871607762

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Registry record

Entity type Organization (Type 2)
Legal business name Providence Medical Foundation
Other name <Unavail>
Practice address 955 W Imperial Hwy Ste 110, Brea, CA, 92821
Phone (714) 449-4900
Enumeration date Aug 18, 2006
Last updated in NPPES Feb 3, 2026

Taxonomy & classification

207Q00000X Family Medicine Physician Allopathic & Osteopathic Physicians Primary
207V00000X Obstetrics & Gynecology Physician Allopathic & Osteopathic Physicians Secondary
261QR0200X Radiology Clinic/Center Ambulatory Health Care Facilities Secondary
332BX2000X Oxygen Equipment & Supplies (DME) Suppliers · License 091052001 (CA) Secondary

Authorized official

Name Donald Anderson
Title Assistant Secretary of Enrollments
Phone (425) 358-9786

Other identifiers

Identifier Type State Issuer
GR0062058 Medicaid CA -
LAB76828F Medicaid CA -
GR0062050 Medicaid CA -
GR0062051 Medicaid CA -
GR0062053 Medicaid CA -
GR0062056 Medicaid CA -
GR0062059 Medicaid CA -
GR0062057 Medicaid CA -
GR006205A Medicaid CA -
GR0062054 Medicaid CA -
GR0062055 Medicaid CA -
GR0062052 Medicaid CA -

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 → Validate an NPI →

Frequently asked questions

What is the NPI number for Providence Medical Foundation?
The NPI for Providence Medical Foundation is 1871607762, a Type 2 (organization) record in the CMS NPPES registry.
Who is the authorized official for Providence Medical Foundation?
NPPES lists Donald Anderson (Assistant Secretary of Enrollments) as the authorized official for this organization.

Providers at this address

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Source: CMS NPPES (public data). Snapshot 2026-07-13. Provider record last updated 2026-02-03.