Medical school: NOVA SOUTHEASTERN COLLEGE OF OSTEO MEDICINE
Graduated: 1994
Offers telehealth
NPI: 1699734319
Practice Locations (1)
PROVIDENCE FACEY MEDICAL FOUNDATION
18133 VENTURA BLVD, SUITE 204
TARZANA, CA 913563641
8184667700
Source: CMS National Downloadable File, September 2026.