Graduated: 1998
NPI: 1053336982
Practice Locations (3)
1370 BREA BLVD, SUITE 210
FULLERTON, CA 928354123
PO BOX, SUITE 5143
GARDEN GROVE, CA 92846
1925 MCKINLEY AVE, SUITE F
LA VERNE, CA 917505800
Source: CMS National Downloadable File, September 2026.