Medical school: NEW YORK COLLEGE OF PODIATRIC MEDICINE
Graduated: 1985
NPI: 1386664084
Practice Locations (1)
LAKESIDE MEDICAL ORGANIZATION A MEDICAL GROUP INC
14901 RINALDI ST, SUITE 200 201
MISSION HILLS, CA 913451204
8183658553
Source: CMS National Downloadable File, September 2026.