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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 WAYNE 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) 792-4015
(310) 792-4093
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
—
—
207P00000X
Emergency Medicine Physician
—
—
207Q00000X
Family Medicine Physician
Primary
—
—
207R00000X
Internal Medicine Physician
—
—
207RR0500X
Rheumatology Physician
—
—
207V00000X
Obstetrics & Gynecology Physician
—
—
207X00000X
Orthopaedic Surgery Physician
—
—
208000000X
Pediatrics Physician
—
—
208M00000X
Hospitalist Physician
—
—
261QU0200X
Urgent Care Clinic/Center
—
—
Other
Enumeration date
06/14/2006
Last updated
05/12/2025
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