Graduated: 2022
Offers telehealth
NPI: 1497468953
Practice Locations (2)
PROVIDENCE MEDICAL FOUNDATION
955 W IMPERIAL HWY, SUITE 110
BREA, CA 928213814
7144496900
PROVIDENCE MEDICAL FOUNDATION
1950 SUNNY CREST DR, SUITE 2900
FULLERTON, CA 928353641
7149925350
Source: CMS National Downloadable File, September 2026.