Medical school: NEW YORK MEDICAL COLLEGE
Graduated: 1991
NPI: 1538202155
Practice Locations (4)
PROVIDENCE MEDICAL INSTITUTE
LAGUNA NIGUEL, CA 92677
PROVIDENCE MEDICAL INSTITUTE
18133 VENTURA BLVD, SUITE 302
TARZANA, CA 913563645
8184667770
PROVIDENCE MEDICAL INSTITUTE
18321 CLARK ST
TARZANA, CA 913563501
8188810800
PROVIDENCE MEDICAL INSTITUTE
1220 LA VENTA DR, SUITE 202
WESTLAKE VILLAGE, CA 913613750
8054490066
Source: CMS National Downloadable File, September 2026.