Graduated: 1995
Offers telehealth
NPI: 1841280864
Practice Locations (2)
PROVIDENCE SAINT JOHNS MEDICAL FOUNDATION
12555 W JEFFERSON BLVD
LOS ANGELES, CA 900667032
PROVIDENCE SAINT JOHNS MEDICAL FOUNDATION
2336 SANTA MONICA BLVD, SUITE 204
SANTA MONICA, CA 904042938
3108296789
Source: CMS National Downloadable File, September 2026.