Graduated: 1994
NPI: 1750347969
Practice Locations (2)
PROVIDENCE MEDICAL FOUNDATION
2700 DOLBEER ST
EUREKA, CA 955014736
7074458121
SCRIPPS HEALTH
10666 N TORREY PINES RD
LA JOLLA, CA 920371027
8585549100
Source: CMS National Downloadable File, September 2026.