Graduated: 2019
NPI: 1679125231
Practice Locations (3)
PROVIDENCE MEDICAL INSTITUTE
GLENDALE, CA 91202
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.