Graduated: 2021
NPI: 1427524974
Practice Locations (3)
16255 VENTURA BLVD, SUITE 509
ENCINO, CA 914362305
PO BOX, SUITE 10365
GLENDALE, CA 912093365
1515 WILSHIRE BLVD APT, SUITE 443
LOS ANGELES, CA 900173021
Source: CMS National Downloadable File, September 2026.