Medical school: UNIVERSITY OF SOUTH CAROLINA SCHOOL OF MEDICINE
Graduated: 1975
NPI: 1457304602
Practice Locations (4)
PROVIDENCE MEDICAL INSTITUTE
GLENDALE, CA 91202
PROVIDENCE MEDICAL INSTITUTE
1010 N SEPULVEDA BLVD
MANHATTAN BEACH, CA 902665929
3103766262
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.