Medical school: UNIVERSITY OF CALIFORNIA, GEFFEN SCHOOL OF MEDICINE
Graduated: 2004
NPI: 1003091539
Practice Locations (2)
PROVIDENCE MEDICAL FOUNDATION
200 W CTR ST PROMENADE
ANAHEIM, CA 928053960
PROVIDENCE MEDICAL FOUNDATION
1950 SUNNY CREST DR, SUITE 2900
FULLERTON, CA 928353641
7149925350
Source: CMS National Downloadable File, September 2026.