Medical school: LOMA LINDA UNIVERSITY SCHOOL OF MEDICINE
Graduated: 1989
NPI: 1295776474
Practice Locations (2)
520 S VIRGIL AVE, SUITE 106
Los Angeles, CA 900201416
520 S VIRGIL AVE, SUITE 106
LOS ANGELES, CA 900201416
2132345575
Source: CMS National Downloadable File, September 2026.