Graduated: 1987
NPI: 1124227772
Practice Locations (4)
PROVIDENCE MEDICAL INSTITUTE
21501 AVALON BLVD, SUITE 100
CARSON, CA 907452210
3108356627
PROVIDENCE MEDICAL INSTITUTE
GLENDALE, CA 91202
PROVIDENCE MEDICAL INSTITUTE
1499 W 1ST ST
SAN PEDRO, CA 907323255
3108319482
PROVIDENCE MEDICAL INSTITUTE
2382 CRENSHAW BLVD, SUITE 5
TORRANCE, CA 905013333
3106189200
Source: CMS National Downloadable File, September 2026.