Medical school: UNIVERSITY OF CALIFORNIA, DAVIS SCHOOL OF MEDICINE
Graduated: 1975
Offers telehealth
NPI: 1144336769
Practice Locations (4)
PROVIDENCE MEDICAL INSTITUTE
21501 AVALON BLVD, SUITE 100
CARSON, CA 907452210
3108356627
PROVIDENCE MEDICAL INSTITUTE
LAGUNA NIGUEL, CA 92677
PROVIDENCE MEDICAL INSTITUTE
2801 ATLANTIC AVE
LONG BEACH, CA 908061701
5629332000
PROVIDENCE MEDICAL INSTITUTE
1499 W 1ST ST
SAN PEDRO, CA 907323255
3108319482
Source: CMS National Downloadable File, September 2026.