Graduated: 1980
NPI: 1164527560
Practice Locations (3)
COUNTY OF SANTA CLARA
751 S BASCOM AVE
SAN JOSE, CA 951282604
4088855000
COUNTY OF SANTA CLARA
751 S BASCOM AVE, SANTA CLARA VLY MED
SAN JOSE, CA 951282604
4088855000
COUNTY OF SANTA CRUZ
1400 EMELINE AVE
SANTA CRUZ, CA 950601976
8314544971
Source: CMS National Downloadable File, September 2026.