Graduated: 1990
NPI: 1104859164
Practice Locations (3)
1711 W TEMPLE ST
LOS ANGELES, CA 900267329
6578883008
1711 W TEMPLE ST, SUITE 2056
LOS ANGELES, CA 900265421
SOUTHERN CALIFORNIA MEDICAL CENTER INC
14550 HAYNES ST
VAN NUYS, CA 914111613
8186506700
Source: CMS National Downloadable File, September 2026.