Medical school: NORTHWESTERN UNIVERSITY FEINBERG MEDICAL SCHOOL
Graduated: 1983
Offers telehealth
NPI: 1386662922
Practice Locations (1)
PROVIDENCE FACEY MEDICAL FOUNDATION
11333 SEPULVEDA BLVD
MISSION HILLS, CA 913451116
8183659531
Source: CMS National Downloadable File, September 2026.