Medical school: OHIO UNIVERSITY, COLLEGE OF OSTEOPATHIC MEDICINE
Graduated: 2013
Offers telehealth
NPI: 1558799627
Practice Locations (3)
PROVIDENCE MEDICAL INSTITUTE
21501 AVALON BLVD, SUITE 100
CARSON, CA 907452210
3108356627
PROVIDENCE MEDICAL INSTITUTE
GLENDALE, CA 91202
PROVIDENCE MEDICAL INSTITUTE
21311 MADRONA AVE
TORRANCE, CA 905035970
Source: CMS National Downloadable File, September 2026.