Graduated: 2020
NPI: 1316546708
Practice Locations (2)
PROVIDENCE SAINT JOHNS MEDICAL FOUNDATION
181 S BUENA VISTA ST
BURBANK, CA 915054504
PROVIDENCE SAINT JOHNS MEDICAL FOUNDATION
2336 SANTA MONICA BLVD, SUITE 204
SANTA MONICA, CA 904042938
3108296789
Source: CMS National Downloadable File, September 2026.