Medical school: UNIVERSITY OF CALIFORNIA, SAN DIEGO SCHOOL OF MEDICINE
Graduated: 2004
Offers telehealth
NPI: 1962418806
Practice Locations (4)
PROVIDENCE MEDICAL FOUNDATION
200 W CTR ST PROMENADE
ANAHEIM, CA 928053960
PROVIDENCE MEDICAL FOUNDATION
3300 RENNER DR
FORTUNA, CA 955403120
7077253361
PROVIDENCE MEDICAL FOUNDATION
3307 RENNER DR
FORTUNA, CA 955403119
7144494800
PROVIDENCE MEDICAL FOUNDATION
500 DOYLE PARK DR
SANTA ROSA, CA 954054559
Source: CMS National Downloadable File, September 2026.