Graduated: 2017
NPI: 1760942379
Practice Locations (2)
PROVIDENCE SAINT JOHNS MEDICAL FOUNDATION
1301 20TH ST, SUITE 150
SANTA MONICA, CA 904042050
3105827641
PROVIDENCE SAINT JOHNS MEDICAL FOUNDATION
2336 SANTA MONICA BLVD, SUITE 204
SANTA MONICA, CA 904042938
3108296789
Source: CMS National Downloadable File, September 2026.