Graduated: 1991
NPI: 1447346002
Practice Locations (2)
COUNTY OF SANTA CLARA
1144 S 2ND ST
SAN JOSE, CA 951125974
4089614700
COUNTY OF SANTA CLARA
1887 MONTEREY HWY, SUITE 205
SAN JOSE, CA 951126192
4089614040
Source: CMS National Downloadable File, September 2026.