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Organization
PROVIDENCE MEDICAL INSTITUTE
Active
Organization
PROVIDENCE MEDICAL INSTITUTE
Active
Other names
Providence Little Company of Mary Medical Institute
Organization subpart
No
Provider details
NPI number
Authorized official
DONALD W ANDERSON JR. (ASSISTANT SECRETARY OF ENROLLMENTS)
(425) 358-9786
Entity
Organization
Contact information
Practice address
4101 TORRANCE BLVD, TORRANCE, CA 90503-4607
(310) 793-8075
(310) 793-8195
Mailing address
PO BOX 31001-3029, PASADENA, CA 91110-3029
(310) 793-8075
(310) 793-8195
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
—
—
207P00000X
Emergency Medicine Physician
—
—
207Q00000X
Family Medicine Physician
Primary
—
—
207R00000X
Internal Medicine Physician
—
—
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
—
—
207RR0500X
Rheumatology Physician
—
—
207V00000X
Obstetrics & Gynecology Physician
—
—
207X00000X
Orthopaedic Surgery Physician
—
—
208000000X
Pediatrics Physician
—
—
208M00000X
Hospitalist Physician
—
—
Other
Enumeration date
05/18/2006
Last updated
05/12/2025
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