Medical school: WESTERN UNIVERSITY OF HEALTH SCIENCES COLLEGE OF DENTAL MED
Graduated: 2004
Offers telehealth
NPI: 1073794152
Practice Locations (4)
PROVIDENCE MEDICAL FOUNDATION
101 LAGUNA RD, SUITE 100
FULLERTON, CA 928353601
7149925350
PROVIDENCE MEDICAL FOUNDATION
101 LAGUNA RD, SUITE 200
FULLERTON, CA 928353634
7149925350
PROVIDENCE MEDICAL FOUNDATION
1950 SUNNY CREST DR, SUITE 2900
FULLERTON, CA 928353641
7149925350
PROVIDENCE MEDICAL FOUNDATION
2501 E CHAPMAN AVE
ORANGE, CA 928693204
7146337175
Source: CMS National Downloadable File, September 2026.