Graduated: 2002
NPI: 1053607887
Practice Locations (2)
COUNTY OF LOS ANGELES
12021 S WILMINGTON AVE, ROOM 1059
LOS ANGELES, CA 900593019
COUNTY OF LOS ANGELES
5850 S MAIN ST
LOS ANGELES, CA 900031215
3238976000
Source: CMS National Downloadable File, September 2026.