Medical school: STATE UNIVERSITY OF NEW YORK AT BUFFALO SCHOOL OF MEDICINE
Graduated: 1996
NPI: 1578676334
Practice Locations (7)
PROVIDENCE MEDICAL INSTITUTE
21501 AVALON BLVD, SUITE 100
CARSON, CA 907452210
3108356627
PROVIDENCE MEDICAL INSTITUTE
GLENDALE, CA 91202
PROVIDENCE MEDICAL INSTITUTE
LAGUNA NIGUEL, CA 92677
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
21311 MADRONA AVE
TORRANCE, CA 905035970
PROVIDENCE MEDICAL INSTITUTE
2382 CRENSHAW BLVD, SUITE 5
TORRANCE, CA 905013333
3106189200
Source: CMS National Downloadable File, September 2026.