Providence Medical Foundation
Providence Medical Foundation is a healthcare organization registered as Family Medicine Physician in Brea, CA, holding Type 2 (organization) NPI 1871607762 since 2006. The authorized official on file is Donald Anderson, Assistant Secretary of Enrollments.
✓ Active NPI ✓ Valid NPI checksum
| NPI | 1871607762 |
|---|---|
| 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 | 7144494900 |
| Enumeration date | 2006-08-18 |
| 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 |
|---|---|---|---|---|
| 261QR0200X | Radiology Clinic/Center | Secondary | — | — |
| 207V00000X | Obstetrics & Gynecology Physician | Secondary | — | — |
| 332BX2000X | Oxygen Equipment & Supplies (DME) | Secondary | 091052001 | CA |
| 207Q00000X | Family Medicine Physician | Primary | — | — |
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 | — |
Copy-ready billing details
Provider: Providence Medical Foundation NPI: 1871607762 Taxonomy: 207Q00000X (Family Medicine Physician) Address: 955 W IMPERIAL HWY STE 110, Brea, CA, 92821
Providers at this address
| NPI | Name | Type | Specialty | Location |
|---|---|---|---|---|
| 1518967140 | Anne Ford | Individual | Family Medicine Physician | Brea, CA |
| 1134129182 | Mark Giglio | Individual | Family Medicine Physician | Brea, CA |
| 1861493736 | Bruce Mutter | Individual | Family Medicine Physician | Brea, CA |
| 1750382628 | Andrew Morrison | Individual | Family Medicine Physician | Brea, CA |
| 1902807670 | Robert Ranney | Individual | Family Medicine Physician | Brea, CA |
| 1093700064 | Paulynne Liang | Individual | Internal Medicine Physician | Brea, CA |
| 1760478606 | Christian Lising | Individual | Family Medicine Physician | Brea, CA |
| 1760479992 | Alexandra Duke | Individual | Family Medicine Physician | Brea, CA |
Verify this record
Cross-check NPI 1871607762 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 is the NPI number for Providence Medical Foundation?
Who is the authorized official for Providence Medical Foundation?
Source: CMS NPPES (public data). Snapshot 2026-07-11. Provider record last updated 2026-02-03.