Medical school: OREGON HEALTH SCIENCES UNIVERSITY SCHOOL OF MEDICINE
Graduated: 1980
Offers telehealth
NPI: 1912005422
Practice Locations (1)
PROVIDENCE SAINT JOHNS MEDICAL FOUNDATION
2121 SANTA MONICA BLVD
SANTA MONICA, CA 904042303
3108295511
Source: CMS National Downloadable File, September 2026.