Medical school: CALIFORNIA SCHOOL OF PODIATRIC MEDICINE
Graduated: 2002
NPI: 1366449985
Practice Locations (2)
5400 BALBOA BLVD, SUITE 325
ENCINO, CA 913165226
8189076100
PREMIUM PODIATRY INC
5400 BALBOA BLVD, SUITE 325
ENCINO, CA 913165226
8187820559
Source: CMS National Downloadable File, September 2026.