Medical school: WAYNE STATE UNIVERSITY SCHOOL OF MEDICINE
Graduated: 1995
Offers telehealth
NPI: 1386796209
Practice Locations (2)
1503 S COAST DR, SUITE 120
COSTA MESA, CA 926261526
7144249955
REGENTS OF THE UNIVERSITY OF CALIFORNIA
101 THE CITY DR S
ORANGE, CA 928683201
7144568068
Source: CMS National Downloadable File, September 2026.