Graduated: 2003
Offers telehealth
NPI: 1790716397
Practice Locations (2)
PROVIDENCE MEDICAL INSTITUTE
13349 CAMINITO MAR VILLA
DEL MAR, CA 920143613
PROVIDENCE MEDICAL INSTITUTE
520 N PROSPECT AVE
REDONDO BEACH, CA 902773033
Source: CMS National Downloadable File, September 2026.