Graduated: 1997
NPI: 1255587580
Practice Locations (2)
PROVIDENCE FACEY MEDICAL FOUNDATION
11333 SEPULVEDA BLVD
MISSION HILLS, CA 913451116
8183659531
PROVIDENCE FACEY MEDICAL FOUNDATION
19950 RINALDI ST
PORTER RANCH, CA 913264141
8184032400
Source: CMS National Downloadable File, September 2026.