Graduated: 2008
NPI: 1346677572
Practice Locations (4)
1101 E BROADWAY, 103 SUITE 103
GLENDALE, CA 912051383
501 N MACALY AVE
SAN FERNANDO, CA 913402424
PO BOX, SUITE 920773
SYLMAR, CA 913920773
7465 W LAKE MEAD BLVD, SUITE 100
LAS VEGAS, NV 891281033
Source: CMS National Downloadable File, September 2026.