Medical school: UNIVERSITY OF CALIFORNIA, DAVIS SCHOOL OF MEDICINE
Graduated: 1998
NPI: 1396799672
Practice Locations (2)
PROVIDENCE MEDICAL FOUNDATION
1950 SUNNY CREST DR, SUITE 2900
FULLERTON, CA 928353641
7149925350
BOLSA MEDICAL GROUP
10362 BOLSA AVE
WESTMINSTER, CA 926836763
7145312091
Source: CMS National Downloadable File, September 2026.