Graduated: 1992
NPI: 1073612552
Practice Locations (3)
ALAMEDA HEALTH SYSTEM
13855 E 14TH ST
SAN LEANDRO, CA 945782611
5103576500
PROVIDENCE MEDICAL FOUNDATION
1165 MONTGOMERY DR
SANTA ROSA, CA 954054801
7075463210
PROVIDENCE HEALTH AND SERVICES OREGON
70 BOWER DR
MEDFORD, OR 975013689
5417328300
Source: CMS National Downloadable File, September 2026.