Medical school: NEW YORK COLLEGE OF OSTEO MEDICINE OF NEW YORK INSTITUTE OF TECHNOLOGY
Graduated: 1997
Offers telehealth
NPI: 1679532956
Practice Locations (5)
PROVIDENCE MEDICAL FOUNDATION
1950 SUNNY CREST DR, SUITE 2900
FULLERTON, CA 928353641
7149925350
PROVIDENCE MEDICAL FOUNDATION
2501 E CHAPMAN AVE
ORANGE, CA 928693204
7146337175
PROVIDENCE MEDICAL FOUNDATION
845 W LA VETA AVE
ORANGE, CA 928683930
PROVIDENCE MEDICAL FOUNDATION
2212 E 4TH ST
SANTA ANA, CA 927053870
7146331011
PROVIDENCE MEDICAL FOUNDATION
1095 IRVINE BLVD
TUSTIN, CA 927803526
7145057110
Source: CMS National Downloadable File, September 2026.