Medical school: COLLEGE OF OSTEO MED OF THE PACIFIC AT POMONA
Graduated: 1993
Offers telehealth
NPI: 1972504173
Practice Locations (2)
PROVIDENCE MEDICAL FOUNDATION
1950 SUNNY CREST DR, SUITE 2900
FULLERTON, CA 928353641
7149925350
PROVIDENCE MEDICAL FOUNDATION
4300 ROSE DR
YORBA LINDA, CA 928862026
7145776601
Source: CMS National Downloadable File, September 2026.