Medical school: UNIVERSITY OF ILLINOIS COLLEGE OF MED (CHI/PEOR/ROCK/CHM-URB)
Graduated: 2005
Offers telehealth
NPI: 1306092564
Practice Locations (1)
PROVIDENCE SAINT JOHNS MEDICAL FOUNDATION
2121 SANTA MONICA BLVD
SANTA MONICA, CA 904042303
3108295511
Source: CMS National Downloadable File, September 2026.