Graduated: 2000
Offers telehealth
NPI: 1043317704
Practice Locations (2)
COUNTY OF LOS ANGELES
12021 S WILMINGTON AVE, ROOM 1059
LOS ANGELES, CA 900593019
COUNTY OF LOS ANGELES
2829 S GRAND AVE
LOS ANGELES, CA 900073304
2136997013
Source: CMS National Downloadable File, September 2026.