Graduated: 2019
NPI: 1164072922
Practice Locations (2)
SOUTHERN MONO HEALTH CARE DISTRICT
PO BOX
MAMMOTH LAKES, CA 935460660
SOUTHERN MONO HEALTH CARE DISTRICT
PO BOX, SUITE 660
MAMMOTH LAKES, CA 935460660
Source: CMS National Downloadable File, September 2026.