Graduated: 1984
NPI: 1265483523
Practice Locations (4)
COUNTY OF SAN MATEO
22 W 39TH AVE
SAN MATEO, CA 944034364
COUNTY OF SAN MATEO
22 W 39TH AVE, HOS316MS
SAN MATEO, CA 944034364
COUNTY OF SAN MATEO
222 W 39TH AVE
SAN MATEO, CA 944034364
COUNTY OF SAN MATEO
222 W 39TH AVE, HOS316MS
SAN MATEO, CA 944034364
Source: CMS National Downloadable File, September 2026.