Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Providence Medical Foundation

Organization Urology Physician · NPI 1053616706

Providence Medical Foundation is an Urology Physician in Apple Valley, California. Registered with an NPI since 2011.

In the registry since
2011
Specialties on file
3

Practice location Address checks out

19333 Bear Valley Rd Ste 106
Apple Valley, CA 92308-5148
Phone: (760) 240-5505
Fax: (760) 245-5525
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Urology Physician (primary) Taxonomy 208800000X
Radiology Clinic/Center Taxonomy 261QR0200X
Durable Medical Equipment & Medical Supplies Taxonomy 332B00000X

Record details

NPI number1053616706
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Donald Anderson — Assistant Secretary Of Enrollments · (425) 358-9786
Other names St Joseph Heritage Healthcare; St Jude Hospital Yorba Linda
NPI enumeratedJanuary 11, 2011
Last updated in NPPESDecember 1, 2025
Certification dateDecember 1, 2025
Mailing addressPo Box 31001 - 1920, Pasadena, CA 91110-1920

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