Medical school: UNIVERSITY OF SOUTHERN CALIFORNIA KECK SCHOOL OF MEDICINE
Graduated: 1984
Also: GENERAL SURGERY
NPI: 1760554232
Practice Locations (4)
PROVIDENCE MEDICAL FOUNDATION
1514 VALLEY VISTA DR
DIAMOND BAR, CA 917653929
9098601144
PROVIDENCE MEDICAL FOUNDATION
100 E VALENCIA MESA DR, SUITE 105
FULLERTON, CA 928353816
7148713006
PROVIDENCE MEDICAL FOUNDATION
1950 SUNNY CREST DR, SUITE 2900
FULLERTON, CA 928353641
7149925350
PROVIDENCE MEDICAL FOUNDATION
2151 N HARBOR BLVD
FULLERTON, CA 928353820
7144465100
Source: CMS National Downloadable File, September 2026.