Graduated: 2021
NPI: 1558030130
Practice Locations (2)
PROVIDENCE FACEY MEDICAL FOUNDATION
3413 W PACIFIC AVE, SUITE 100
BURBANK, CA 915051598
8185617589
PROVIDENCE FACEY MEDICAL FOUNDATION
19950 RINALDI ST
PORTER RANCH, CA 913264141
8184032400
Source: CMS National Downloadable File, September 2026.