Graduated: 2006
NPI: 1184364663
Practice Locations (3)
5767 W CENTURY BLVD, SUITE 400
Los Angeles, CA 900455631
12021 WILMINGTON AVE, BLDG 11
LOS ANGELES, CA 900593019
5767 W CENTURY BLVD, SUITE 400
LOS ANGELES, CA 900455631
Source: CMS National Downloadable File, September 2026.