Medical school: UNIVERSITY OF CALIFORNIA, GEFFEN SCHOOL OF MEDICINE
Graduated: 1996
Offers telehealth
NPI: 1437181369
Practice Locations (1)
PROVIDENCE SAINT JOHNS MEDICAL FOUNDATION
12555 W JEFFERSON BLVD, SUITE 303
LOS ANGELES, CA 900667032
4244435530
Source: CMS National Downloadable File, September 2026.