Graduated: 2020
NPI: 1013409325
Practice Locations (3)
402 W BROADWAY, SUITE 400
SAN DIEGO, CA 921013554
4150 INGRAHAM ST, APT 3
SAN DIEGO, CA 921095457
5820 OBERLIN DR, SUITE 112
SAN DIEGO, CA 921213742
Source: CMS National Downloadable File, September 2026.