Graduated: 1999
Offers telehealth
NPI: 1194857656
Practice Locations (2)
PROVIDENCE MEDICAL INSTITUTE
29525 CANWOOD ST, SUITE 300
AGOURA HILLS, CA 913014232
8187062477
PROVIDENCE MEDICAL INSTITUTE
LAGUNA NIGUEL, CA 92677
Source: CMS National Downloadable File, September 2026.