Medical school: UNIVERSITY OF SOUTHERN CALIFORNIA KECK SCHOOL OF MEDICINE
Graduated: 1994
NPI: 1063446532
Practice Locations (2)
COUNTY OF LOS ANGELES
12021 S WILMINGTON AVE, ROOM 1059
LOS ANGELES, CA 900593019
COUNTY OF LOS ANGELES
1000 W CARSON ST
TORRANCE, CA 905022004
3102225026
Source: CMS National Downloadable File, September 2026.