Graduated: 1977
NPI: 1023047669
Practice Locations (3)
2105 BEVERLY BLVD, SUITE 131
Los Angeles, CA 900572263
2105 BEVERLY BLVD, SUITE 131
LOS ANGELES, CA 900572263
2134138836
2105 BEVERLY BLVD, SUITE 131
LOS ANGELES, CA 900572263
Source: CMS National Downloadable File, September 2026.