Medical school: CALIFORNIA SCHOOL OF PODIATRIC MEDICINE
Graduated: 1996
Offers telehealth
NPI: 1174618672
Practice Locations (2)
43713 20TH ST W, SUITE 5
LANCASTER, CA 935344628
6619458700
LAKESIDE MEDICAL ORGANIZATION A MEDICAL GROUP INC
14901 RINALDI ST, SUITE 200 201
MISSION HILLS, CA 913451204
8183658553
Source: CMS National Downloadable File, September 2026.