Medical school: ROCKY VISTA UNIVERSITY COLLEGE OF OSTEOPATHIC MED
Graduated: 2019
Offers telehealth
NPI: 1760045785
Practice Locations (3)
PROVIDENCE MEDICAL INSTITUTE
21501 AVALON BLVD, SUITE 100
CARSON, CA 907452210
3108356627
PROVIDENCE MEDICAL INSTITUTE
LAGUNA NIGUEL, CA 92677
PROVIDENCE MEDICAL INSTITUTE
4201 TORRANCE BLVD, SUITE 560
TORRANCE, CA 905034583
3102125360
Source: CMS National Downloadable File, September 2026.