Provider Type Icon

PROVIDENCE MEDICAL FOUNDATION NPI 1386937225


NPI Information

NPI: 1386937225
Provider Name: PROVIDENCE MEDICAL FOUNDATION

Former Legal Business Name: ST JOSEPH HERITAGE HEALTHCARE

Classification: Orthopaedic Surgery - 207X00000X
Entity Type: Organization

CLIA Number: 05D2155228

Address:
2826 HARRIS ST
EUREKA, CA
ZIP 95503
Phone: (707) 443-8066
Get Directions

PROVIDENCE MEDICAL FOUNDATION is an orthopaedic surgery in Eureka, CA. The provider is an orthopaedic surgeon is trained in the preservation, investigation and restoration of the form and function of the extremities, spine and associated structures by medical, surgical and physical means. An orthopaedic surgeon is involved with the care of patients whose musculoskeletal problems include congenital deformities, trauma, infections, tumors, metabolic disturbances of the musculoskeletal system, deformities, injuries and degenerative diseases of the spine, hands, feet, knee, hip, shoulder and elbow in children and adults. An orthopaedic surgeon is also concerned with primary and secondary muscular problems and the effects of central or peripheral nervous system lesions of the musculoskeletal system. PROVIDENCE MEDICAL FOUNDATION NPI is 1386937225. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Former Legal Business Name Is St Joseph Heritage Healthcare.

The provider's business location address is:

2826 HARRIS ST
EUREKA, CA
ZIP 95503-809
Phone: (707) 443-8066
Fax: (707) 268-3251

The provider's authorized official is Jill Ann Duplechan .
The authorized official title is Chief Administrative Officer and has the following contact phone number (714) 347-7790.

The CLIA number assigned to this NPI record is 05D2155228 - physician office with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 5/25/2011 and was last updated on 6/15/2021.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207X00000XOrthopaedic SurgeryYes
2332B00000XDurable Medical Equipment & Medical SuppliesNo

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
16852510001OTHERCALIFORNIANSC

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.