Graduated: 2003
NPI: 1679587448
Practice Locations (4)
PROVIDENCE MEDICAL INSTITUTE
21501 AVALON BLVD, SUITE 100
CARSON, CA 907452210
3108356627
PROVIDENCE MEDICAL INSTITUTE
LAGUNA NIGUEL, CA 92677
PROVIDENCE MEDICAL INSTITUTE
2801 ATLANTIC AVE
LONG BEACH, CA 908061701
5629332000
PROVIDENCE MEDICAL INSTITUTE
21311 MADRONA AVE
TORRANCE, CA 905035970
Source: CMS National Downloadable File, September 2026.