Graduated: 2025
NPI: 1316894157
Practice Locations (3)
PO BOX, SUITE 50938
LOS ANGELES, CA 90074
PO BOX, SUITE 50938
LOS ANGELES, CA 900740938
215 N MARENGO AVE, SUITE 201
PASADENA, CA 911011532
Source: CMS National Downloadable File, September 2026.