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PROVIDENCE MEDICAL INSTITUTE
NPI 1609358977
Hospitalist in Torrance, CA

Active since September 04, 2018CLIA Certified · 4 labs
4101 TORRANCE BLVD, TORRANCE, CA 90503(310) 303-6833 Get Directions Write a Review

NPPES record last updated: September 4, 2018. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Providence Medical Institute NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PROVIDENCE MEDICAL INSTITUTE (NPI 1609358977) is a healthcare organization registered as a hospitalist in Torrance, California and active in the NPI registry since September 2018. The organization holds 4 active CLIA laboratory certificates, maintains 6 additional practice locations, and lists Donald Wayne Anderson, Assistant Secretary-enrollment, as its authorized official.

NPPES Registry Identity

NPI1609358977
Entity TypeOrganization
Primary Taxonomy208M00000X
Legal Business NamePROVIDENCE MEDICAL INSTITUTE
Location Address4101 TORRANCE BLVDTorrance, CA 90503-4607
Mailing Address21311 Madrona Ave Ste 101Torrance, CA 90503-5970 · (310) 792-4015 · Fax (310) 792-4093
Phone(310) 303-6833
Organization SubpartNo
Authorized OfficialDonald Wayne AndersonAssistant Secretary-enrollment · (425) 525-5392
Enumeration DateSeptember 4, 2018
✔ NPI 1609358977 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyHospitalistAllopathic & Osteopathic Physicians
Taxonomy Code208M00000X
Definition
Hospitalists are physicians whose primary professional focus is the general medical care of hospitalized patients. Their activities include patient care, teaching, research, and leadership related to Hospital Medicine. The term 'hospitalist' refers to physicians whose practice emphasizes providing care for hospitalized patients.
4101 TORRANCE BLVD, Torrance, CA 90503
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Secondary Practice Locations 6

Location 115031 Rinaldi StMission Hills, CA 91345-1207 · Phone (818) 496-4610
Location 22121 Santa Monica BlvdSanta Monica, CA 90404-2303 · Phone (310) 792-4015
Location 3501 S Buena Vista StBurbank, CA 91505-4809 · Phone (818) 847-3893
Location 418321 Clark StTarzana, CA 91356-3501 · Phone (818) 708-5199
Location 51300 W 7th StSan Pedro, CA 90732-3505 · Phone (310) 514-5401
Location 61386 W 7th StSan Pedro, CA 90732-3517 · Phone (310) 514-5401

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA 4

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Accreditation 05D0561363

Providence Medical Institute · Burbank, CA
Active · expires Dec 8, 2027
CLIA Number05D0561363
Laboratory TypePhysician Office
Certificate Effective DateDecember 9, 2025
Certificate Expiration DateDecember 8, 2027
Laboratory DirectorDr. Timothy S. Kristedja
Laboratory Phone(310) 792-4056
Laboratory LocationProvidence Medical Institute181 South Buena Vista St 4th Fl, Burbank, CA 91505
CLIA data matches this NPI record on: Name
This is a certificate that is issued to a laboratory on the basis of the laboratory's accreditation by an accreditation organization approved by CMS.

Certificate for Provider-Performed Microscopy Procedures (PPMP) 05D2024522

Providence Medical Institute · Burbank, CA
Active · expires Nov 18, 2027
CLIA Number05D2024522
Laboratory TypePhysician Office
Certificate Effective DateNovember 19, 2025
Certificate Expiration DateNovember 18, 2027
Laboratory DirectorDavid Sato
Laboratory Phone(310) 792-4086
Laboratory LocationProvidence Medical Institute201 S Buena Vista St Ste 100, Burbank, CA 91505
CLIA data matches this NPI record on: Name
This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.

Certificate of Waiver 05D0956399

Providence Medical Institute · Tarzana, CA
Active · expires Jan 26, 2027
CLIA Number05D0956399
Laboratory TypePhysician Office
Certificate Effective DateJanuary 27, 2025
Certificate Expiration DateJanuary 26, 2027
Laboratory DirectorBenjamin S. Simon MD
Laboratory Phone(818) 345-5580
Laboratory LocationProvidence Medical Institute18370 Burbank Boulevard Suite 707, Tarzana, CA 91356
CLIA data matches this NPI record on: Name
This certificate is issued to a laboratory to perform only waived tests.

Certificate for Provider-Performed Microscopy Procedures (PPMP) 05D2155910

Providence Medical Institute · Tarzana, CA
Active · expires Oct 7, 2026
CLIA Number05D2155910
Laboratory TypePhysician Office
Certificate Effective DateOctober 8, 2024
Certificate Expiration DateOctober 7, 2026
Laboratory DirectorFrederick Kohn
Laboratory Phone(818) 344-0960
Laboratory LocationProvidence Medical Institute18411 Clark Street Ste 102, Tarzana, CA 91356
CLIA data matches this NPI record on: Name
This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.

Medical Equipment Supplier Medicare DMEPOS 4

Medicare supplier enrollment and the product categories Little Company Of Maryland Medical carries, from the Medicare DMEPOS supplier directory.

Little Company Of Maryland Medical

DMEPOS supplier · Torrance, CAOperated by Providence Health System Southern California
⋮

Does not accept Medicare assignment

Little Company Of Maryland Medical has not agreed to accept the Medicare-approved amount as full payment for covered equipment and supplies. Medicare patients may be charged more than the Medicare-approved amount; confirm the expected cost with the supplier before ordering.

PTAN (Medicare Supplier Number)20576831
Medicare Participant SinceNovember 1, 2005
Supplier Location4101 Torrance BlvdTorrance, CA 90503
Phone(310) 303-5777
Supplier Specialties
Pharmacy

Medicare Product Categories

Epoetin
Epoetin is a man-made version of human erythropoietin (EPO)
Immunosuppressive Drugs
Immunosuppressive drugs require dosage, frequency, and route of administration to prevent or treat the rejection of an organ transplant
Oral Anticancer Drugs
FDA anticancer drugs
Oral Antiemetic Drugs
FDA antiemetic drugs
Product categories are from the Medicare DMEPOS supplier directory. Contact the supplier to confirm current availability of specific items.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

PROVIDENCE LITTLE COMPANY OF MARY MEDICAL CENTER TORRANCE
General Acute Care Hospital
4101 TORRANCE BLVD
TORRANCE, CA 90503
Los Angeles County (310) 303-6840
FLORA AMY LEE
Pharmacist
4101 TORRANCE BLVD
TORRANCE, CA 90503
Los Angeles County (310) 540-7676
AZIZ ZAOUADI NP
Nurse Practitioner (Family)
4101 TORRANCE BLVD
TORRANCE, CA 90503
Los Angeles County (323) 494-7440
LEAH SUZANNE GLAVAN BSN RN CIS
Clinical Nurse Specialist (Informatics)
4101 TORRANCE BLVD
TORRANCE, CA 90503
Los Angeles County (310) 540-7676
ADVANCED IMAGING OF SOUTH BAY, INC.
Radiology (Diagnostic Radiology)
4101 TORRANCE BLVD
TORRANCE, CA 90503
Los Angeles County (310) 303-5750
NICHOLAS J MONDEK
Anesthesiology
4101 TORRANCE BLVD
TORRANCE, CA 90503
Los Angeles County (310) 540-7676
THU LAN TRAN
Pharmacist
4101 TORRANCE BLVD
TORRANCE, CA 90503
Los Angeles County (310) 303-5770
NICHOLAS SAADE MD
Emergency Medicine
4101 TORRANCE BLVD
TORRANCE, CA 90503
Los Angeles County (310) 303-5600

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Providence Medical Institute's NPI number?

The NPI number for Providence Medical Institute is 1609358977. It was assigned to this organization in the NPPES registry on September 4, 2018.

Where is Providence Medical Institute located?

Providence Medical Institute is located at 4101 Torrance Blvd, Torrance, CA 90503. The listed phone number is (310) 303-6833.

What is Providence Medical Institute's specialty?

The primary specialty registered for this NPI is Hospitalist with taxonomy code 208M00000X.

Does Providence Medical Institute accept Medicare assignment for medical equipment?

No. As a Medicare medical equipment supplier, Little Company Of Maryland Medical does not accept Medicare assignment for equipment and supplies, so patients may be charged more than the Medicare-approved amount. Confirm the expected cost with the supplier before ordering.

Does Providence Medical Institute hold CLIA laboratory certificates?

Yes. 4 active CLIA laboratory certificates are associated with this NPI under the federal Clinical Laboratory Improvement Amendments program. The certificates are listed in the CLIA Laboratory Certificates section above.

When was this NPI record last updated?

The NPPES record for Providence Medical Institute was last updated on September 4, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.