PROVIDENCE MEDICAL INSTITUTE (NPI# 1417915760) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417915760 |
| Entity Type | Organization |
| Organization Name | PROVIDENCE MEDICAL INSTITUTE |
| Other Organization Name | PROVIDENCE LITTLE COMPANY OF MARY MEDICAL INSTITUTE |
| Practice Address |
4101 Torrance Blvd Torrance CA 90503-4607 |
| Mailing Address |
21311 Madrona Ave Ste 101 Torrance CA 90503-5970 |
| Practice Telephone | 3107938075 |
| Practice Fax Number | 3107938195 |
| Mailing Telephone | 3107924015 |
| Mailing Fax Number | 3107924093 |
| Enumeration Date | 2006-05-03 |
| Last Update Date | 2018-11-28 |
| Authorized Official Name | MR. DONALD WAYNE ANDERSON (ASSISTANT SECRETARY-ENROLLMENT) |
| Authorized Official Telephone | 4255255392 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207V00000X | Obstetrics & Gynecology | Allopathic & Osteopathic Physicians | ||
| N | 207X00000X | Orthopaedic Surgery | Allopathic & Osteopathic Physicians | ||
| N | 208000000X | Pediatrics | Allopathic & Osteopathic Physicians | ||
| N | 208M00000X | Hospitalist | Allopathic & Osteopathic Physicians | ||
| N | 207RR0500X |
Internal Medicine Specialization: Rheumatology |
Allopathic & Osteopathic Physicians | ||
| N | 207N00000X | Dermatology | Allopathic & Osteopathic Physicians | ||
| N | 207P00000X | Emergency Medicine | Allopathic & Osteopathic Physicians | ||
| N | 207R00000X | Internal Medicine | Allopathic & Osteopathic Physicians | ||
| Y | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians | ||
| N | 207RE0101X |
Internal Medicine Specialization: Endocrinology, Diabetes & Metabolism |
Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Providence Little Company of Mary Medical Institute | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609358977 | Providence Medical Institute | Hospitalist | 4101 Torrance Blvd, Torrance, CA 90503-4607 | 2018-09-04 |
| 1972546091 | Providence Medical Institute | Internal Medicine | 4101 Torrance Blvd, Torrance, CA 90503-4607 | 2006-06-14 |
| 1760425862 | Providence Medical Institute | Orthopaedic Surgery | 4101 Torrance Blvd, Torrance, CA 90503-4607 | 2006-06-14 |
| 1356394175 | Providence Medical Institute | Dermatology | 4101 Torrance Blvd, Torrance, CA 90503-4607 | 2006-05-19 |
| 1235182569 | Providence Medical Institute | Internal Medicine | 4101 Torrance Blvd, Torrance, CA 90503-4607 | 2006-05-18 |
| 1376594671 | Providence Medical Institute | Family Medicine | 4101 Torrance Blvd, Torrance, CA 90503-4607 | 2006-05-12 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Oregon Corporations, Companies and Business Names | PROVIDENCE MEDICAL INSTITUTE | 1801 Lind Ave Sw, Renton, WA 98057 |
| Washington State Corporations | PROVIDENCE MEDICAL INSTITUTE | Dept of Legal Affairs, 1801 Lind Ave. Sw, Renton, WA 98057 |
| Colorado Business Entities | Providence Medical Institute | 1801 Lind Ave. Sw, Renton, WA 98057 |
| Street Address |
4101 TORRANCE BLVD |
| City | TORRANCE |
| State | CA |
| Zip Code | 90503-4607 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437142312 | Little Co Pharmacy | Pharmacy | 4101 Torrance Blvd, Torrance, CA 90503-4607 | 2005-08-25 |
| 1265044143 | Vanessa Escobar | Student in an Organized Health Care Education/Training Program | 4101 Torrance Blvd, Torrance, CA 90503-4607 | 2020-08-20 |
| 1538782149 | Sabrina Rae Verzosa Co | Pharmacist | 4101 Torrance Blvd, Torrance, CA 90503-4607 | 2020-05-19 |
| 1689210718 | Daniel Abanoub Keroles | Pharmacist | 4101 Torrance Blvd, Torrance, CA 90503-4607 | 2019-11-25 |
| 1134761091 | Zahra Esmail D O Professional Corp | Internal Medicine | 4101 Torrance Blvd, Torrance, CA 90503-4607 | 2019-10-11 |
| 1598312498 | Jonathan Malcolm Rojas | Nurse Practitioner | 4101 Torrance Blvd, Torrance, CA 90503-4607 | 2019-08-25 |
| 1497308936 | Katelyn Hicks | Nurse Practitioner | 4101 Torrance Blvd, Torrance, CA 90503-4607 | 2019-07-23 |
| 1780140780 | Shahida P Meghani | Nurse Practitioner | 4101 Torrance Blvd, Torrance, CA 90503-4607 | 2019-02-14 |
| 1609358977 | Providence Medical Institute | Hospitalist | 4101 Torrance Blvd, Torrance, CA 90503-4607 | 2018-09-04 |
| 1750869566 | Providence Little Company of Mary, Torrance | General Acute Care Hospital | 4101 Torrance Blvd, Torrance, CA 90503-4607 | 2018-08-02 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013562180 | Jason Anthony Maglinao | Chiropractor | 21010 Anza Ave., #12, Torrance, CA 90503 | 2019-08-06 |
| 1891288890 | Ehab Samaan Dds Inc | Dentist | 19019 Hawthorne Blvd Ste 100b, Torrance, CA 90503 | 2018-06-13 |
| 1740771435 | Icare California House Call Practice LLC | Nurse Practitioner | 4460 Spencer St, Torrance, CA 90503 | 2018-05-29 |
| 1396258729 | South Bay Home Care, Inc., Dba Always Best Care - South Bay | In Home Supportive Care | 370 S. Crenshaw Blvd., Ste. E106, Torrance, CA 90503 | 2017-11-07 |
| 1770093023 | Home Care Professional Services, Inc. | In Home Supportive Care | 3838 West Carson Street, Suite 208, Torrance, CA 90503 | 2017-10-01 |
| 1003355686 | Mona Nejad | Dentist | 4305 Torrance Blvd Ste 103, Torrance, CA 90503 | 2017-02-16 |
| 1497114722 | Jacqueline Martinez | Technician, Other | 4201 Torrance Blvd Suite 190, Torrance, CA 90503 | 2016-02-15 |
| 1093196255 | Hanmo Gu | Chiropractor | 3510 Torrance Blvd., Ste 106, Torrance, CA 90503 | 2015-06-13 |
| 1164813341 | Aimee Y Miyazawa | Specialist/Technologist | 20501 Earl St. Ste. 3, Torrance, CA 90503 | 2015-02-10 |
| 1396145231 | Nicole Soghomonian | Social Worker | 5010 Merrill St, Torrance, CA 90503 | 2014-08-28 |
| Find all providers in zip 90503 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417554023 | Hameed A. Khan, M.d., Inc. | Family Medicine | 3655 Lomita Blvd Ste 421, Torrance, CA 90505-1934 | 2020-10-06 |
| 1306495908 | Global Grace Medical Services Inc | Family Medicine | 21171 S Western Ave Ste 2710, Torrance, CA 90501-1728 | 2019-09-06 |
| 1386298685 | Shaw Medical Group Professional Corporation | Family Medicine | 1001 W Carson St Ste I, Torrance, CA 90502-2051 | 2019-07-25 |
| 1982137212 | Amanda L Jamal | Family Medicine | 1020 Acacia Ave, Torrance, CA 90501-2010 | 2017-04-04 |
| 1285170613 | Winnel Inc. | Family Medicine | 24554 Hawthorne Blvd, Torrance, CA 90505-6807 | 2017-01-09 |
| 1841602521 | Sheena Malik | Family Medicine | 21311 Madrona Ave Ste 100a, Torrance, CA 90503 | 2014-05-29 |
| 1235477498 | Pacific Coast Osteopathy | Family Medicine | 21311 Hawthorne Blvd, Suite 103, Torrance, CA 90503 | 2013-01-23 |
| 1376828582 | William Momary | Family Medicine | 19915 Tomlee Ave., Torrance, CA 90503-1154 | 2011-10-19 |
| 1639479041 | Derek Mcgrath Browne | Family Medicine | 22719 Hawthorne Blvd, Torrance, CA 90505-3613 | 2010-11-01 |
| 1306150149 | Mizuta Medical Group, Inc. | Family Medicine | 3655 Lomita Blvd Ste 115, Torrance, CA 90505-1906 | 2010-08-04 |
| Find all providers in TORRANCE | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.