Graduated: 2019
NPI: 1629616412
Practice Locations (2)
PROVIDENCE SAINT JOHNS MEDICAL FOUNDATION
2121 SANTA MONICA BLVD
SANTA MONICA, CA 904042303
3108295511
CEP AMERICA - CALIFORNIA
2121 SANTA MONICA BLVD
SANTA MONICA, CA 904042303
3108295511
Source: CMS National Downloadable File, September 2026.