Providence Medical Institute

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

PROVIDENCE MEDICAL INSTITUTE

Practice address

4101 Torrance Blvd
Torrance, CA 90503-4607

Phone

(310) 793-8075

Fax

(310) 793-8195

NPI assigned

May 12, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Kelly Kurcz

Title

Cheif Operating Officer

Phone

(310) 793-8075

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Other NPIs on the same Medicare enrollment 5

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Providence Medical Institute

  • Family Medicine Physician
  • Torrance, CA
  • NPI 1235182569

  O20031121000910

  Same enrollment
• Providence Medical Institute

  • Family Medicine Physician
  • Torrance, CA
  • NPI 1356394175

  O20031121000910

  Same enrollment
• Providence Medical Institute

  • Family Medicine Physician
  • Torrance, CA
  • NPI 1417915760

  O20031121000910

  Same enrollment
• Providence Medical Institute

  • Family Medicine Physician
  • Torrance, CA
  • NPI 1760425862

  O20031121000910

  Same enrollment
• Providence Medical Institute

  • Family Medicine Physician
  • Torrance, CA
  • NPI 1972546091

  O20031121000910

  Same enrollment

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

• Pacific Endo-Surgical Center LP

  • Ambulatory Surgical Clinic/Center
  • Torrance, CA
  • NPI 1588867030

  Member Of

  NPD member

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1147392000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1297209600000",
    "number": "1376594671",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4101 TORRANCE BLVD",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "905034607",
            "telephone_number": "310-793-8075",
            "fax_number": "310-793-8195"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4101 TORRANCE BLVD",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "905034607",
            "telephone_number": "310-793-8075",
            "fax_number": "310-793-8195"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROVIDENCE MEDICAL INSTITUTE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-12",
        "last_updated": "2011-02-09",
        "status": "A",
        "authorized_official_last_name": "KURCZ",
        "authorized_official_first_name": "KELLY",
        "authorized_official_title_or_position": "CHEIF OPERATING OFFICER",
        "authorized_official_telephone_number": "310-793-8075"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Providence Health System Southern California Dba LCM Subacute Care Ctr
• Providence Little Company of Mary Medical Center Torrance
• Providence Little Company of Mary, Torrance
• Providence Medical Institute
• Providence Medical Institute
• Providence Medical Institute
• Providence Medical Institute
• Providence Medical Institute
• Providence Medical Institute
• Providence Trinitycare Hospice

• Family Medicine Physician in Torrance, CA
• Providers in Torrance, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.