Medical school: ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI
Graduated: 2011
NPI: 1679863641
Practice Locations (2)
PROVIDENCE MEDICAL FOUNDATION
2700 DOLBEER ST
EUREKA, CA 955014736
7074458121
PERMANENTE MEDICAL GROUP INC
4601 DALE RD
MODESTO, CA 953569718
2097355000
Source: CMS National Downloadable File, September 2026.