Medical school: UNIVERSITY OF CALIFORNIA, DAVIS SCHOOL OF MEDICINE
Graduated: 2006
NPI: 1497953590
Practice Locations (1)
LAKESIDE MEDICAL ORGANIZATION A MEDICAL GROUP INC
191 S BUENA VISTA ST, SUITE 150
BURBANK, CA 915054522
8182955920
Source: CMS National Downloadable File, September 2026.