Medical school: HAHNEMANN UNIVERSITY COLLEGE OF MEDICINE
Graduated: 1983
Offers telehealth
NPI: 1710143326
Practice Locations (1)
PROVIDENCE SAINT JOHNS MEDICAL FOUNDATION
2021 SANTA MONICA BLVD, SUITE 245E
SANTA MONICA, CA 904042132
3108294403
Source: CMS National Downloadable File, September 2026.