Medical school: UNIVERSITY OF CALIFORNIA, GEFFEN SCHOOL OF MEDICINE
Graduated: 1992
Offers telehealth
NPI: 1073526729
Practice Locations (1)
PROVIDENCE MEDICAL FOUNDATION
500 DOYLE PARK DR, SUITE 303
SANTA ROSA, CA 954054559
7073038300
Source: CMS National Downloadable File, September 2026.