Graduated: 2020
NPI: 1477280626
Practice Locations (3)
12913 HARBOR BLVD, SUITE Q 3 292
Garden Grove, CA 928405856
2512 FOOTHILL BLVD, SUITE 4
LA CRESCENTA, CA 912143506
19322 JESSE LN, SUITE 200
RIVERSIDE, CA 925085072
Source: CMS National Downloadable File, September 2026.