Graduated: 2003
NPI: 1760590897
Practice Locations (3)
PROVIDENCE MEDICAL INSTITUTE
181 S BUENA VISTA ST
BURBANK, CA 915054504
PROVIDENCE MEDICAL INSTITUTE
501 S BUENA VISTA ST
BURBANK, CA 915054809
8188473022
PROVIDENCE MEDICAL INSTITUTE
LAGUNA NIGUEL, CA 92677
Source: CMS National Downloadable File, September 2026.