Medical school: UNIVERSITY OF SOUTHERN CALIFORNIA KECK SCHOOL OF MEDICINE
Graduated: 1993
Also: GENERAL PRACTICE
Offers telehealth
NPI: 1588760508
Practice Locations (1)
PROVIDENCE SAINT JOHNS MEDICAL FOUNDATION
12555 W JEFFERSON BLVD, SUITE 301
LOS ANGELES, CA 900667032
4244435555
Source: CMS National Downloadable File, September 2026.