Graduated: 2008
NPI: 1235374596
Practice Locations (2)
COUNTY OF LOS ANGELES
12021 S WILMINGTON AVE, ROOM 1059
LOS ANGELES, CA 900593019
COUNTY OF LOS ANGELES
1000 W CARSON ST
TORRANCE, CA 905022004
3102225026
Source: CMS National Downloadable File, September 2026.