Medical school: UNIVERSITY OF SOUTHERN CALIFORNIA KECK SCHOOL OF MEDICINE
Graduated: 1979
NPI: 1003864737
Practice Locations (4)
PROVIDENCE MEDICAL FOUNDATION
100 E VALENCIA MESA DR, SUITE 105
FULLERTON, CA 928353816
7148713006
PROVIDENCE MEDICAL FOUNDATION
101 LAGUNA RD, SUITE 100
FULLERTON, CA 928353601
7149925350
PROVIDENCE MEDICAL FOUNDATION
1950 SUNNY CREST DR, SUITE 2900
FULLERTON, CA 928353641
7149925350
PROVIDENCE MEDICAL FOUNDATION
4300 ROSE DR
YORBA LINDA, CA 928862026
7145776601
Source: CMS National Downloadable File, September 2026.