Medical school: UNIVERSITY OF CALIFORNIA, SAN DIEGO SCHOOL OF MEDICINE
Graduated: 1977
Offers telehealth
NPI: 1053363499
Practice Locations (5)
PROVIDENCE MEDICAL INSTITUTE
GLENDALE, CA 91202
PROVIDENCE MEDICAL INSTITUTE
LAGUNA NIGUEL, CA 92677
PROVIDENCE MEDICAL INSTITUTE
2801 ATLANTIC AVE
LONG BEACH, CA 908061701
5629332000
PROVIDENCE MEDICAL INSTITUTE
1300 W 7TH ST
SAN PEDRO, CA 907323505
3103037496
PROVIDENCE MEDICAL INSTITUTE
21311 MADRONA AVE
TORRANCE, CA 905035970
Source: CMS National Downloadable File, September 2026.