Graduated: 2017
NPI: 1477065183
Practice Locations (2)
COUNTY OF LOS ANGELES
12021 S WILMINGTON AVE, ROOM 1059
LOS ANGELES, CA 900593019
COUNTY OF LOS ANGELES
14445 OLIVE VIEW DR
SYLMAR, CA 913421437
8183643001
Source: CMS National Downloadable File, September 2026.