Graduated: 2020
NPI: 1073142501
Practice Locations (2)
NORTHERN INYO HEALTHCARE DISTRICT
150 PIONEER LN
BISHOP, CA 935142556
7608735811
SOUTHERN MONO HEALTH CARE DISTRICT
85 SIERRA PARK RD
MAMMOTH LAKES, CA 935462073
7609343311
Source: CMS National Downloadable File, September 2026.