Medical school: COLLEGE OF OSTEO MED OF THE PACIFIC AT POMONA
Graduated: 1997
Offers telehealth
NPI: 1164422671
Practice Locations (5)
PROVIDENCE MEDICAL FOUNDATION
1514 VALLEY VISTA DR
DIAMOND BAR, CA 917653929
9098601144
PROVIDENCE MEDICAL FOUNDATION
100 E VALENCIA MESA DR, SUITE 105
FULLERTON, CA 928353816
7148713006
PROVIDENCE MEDICAL FOUNDATION
1835 SUNNY CREST DR
FULLERTON, CA 928353616
7144465101
PROVIDENCE MEDICAL FOUNDATION
1837 SUNNY CREST DR
FULLERTON, CA 928353616
7144465831
PROVIDENCE MEDICAL FOUNDATION
1950 SUNNY CREST DR, SUITE 2900
FULLERTON, CA 928353641
7149925350
Source: CMS National Downloadable File, September 2026.