Medical school: ILLINOIS COLLEGE OF OPTOMETRY AT CHICAGO
Graduated: 2015
NPI: 1083095699
Practice Locations (2)
MARSHALL B KETCHUM UNIVERSITY
3916 S BROADWAY
LOS ANGELES, CA 900371307
3232349137
SOUTHERN CALIFORNIA PERMANENTE MEDICAL GROUP
6041 CADILLAC AVE
LOS ANGELES, CA 900341702
8009548000
Source: CMS National Downloadable File, September 2026.