Graduated: 1990
NPI: 1336254796
Practice Locations (3)
2664 29TH ST
Santa Monica, CA 904052916
2318 16TH ST, SUITE 9
SANTA MONICA, CA 904052643
2664 29TH ST
SANTA MONICA, CA 904052916
3103928259
Source: CMS National Downloadable File, September 2026.