Graduated: 2023
NPI: 1619659539
Practice Locations (2)
PROVIDENCE SAINT JOHNS MEDICAL FOUNDATION
12414 EXPOSITION BLVD
LOS ANGELES, CA 900641016
3102727640
PROVIDENCE SAINT JOHNS MEDICAL FOUNDATION
2336 SANTA MONICA BLVD, SUITE 204
SANTA MONICA, CA 904042938
3108296789
Source: CMS National Downloadable File, September 2026.