Graduated: 2024
NPI: 1003652348
Practice Locations (3)
2230 W LINCOLN AVE APT, SUITE 216
Anaheim, CA 928016511
11103 VENICE BLVD
LOS ANGELES, CA 900346914
5901 W CENTURY BLVD, SUITE 750
LOS ANGELES, CA 900455443
Source: CMS National Downloadable File, September 2026.