Medical school: UNIVERSITY OF SOUTHERN CALIFORNIA KECK SCHOOL OF MEDICINE
Graduated: 1993
NPI: 1285641837
Practice Locations (3)
PROVIDENCE MEDICAL INSTITUTE
181 S BUENA VISTA ST
BURBANK, CA 915054504
PROVIDENCE MEDICAL INSTITUTE
501 S BUENA VISTA ST
BURBANK, CA 915054809
8188473022
PROVIDENCE MEDICAL INSTITUTE
LAGUNA NIGUEL, CA 92677
Source: CMS National Downloadable File, September 2026.