Medical school: STATE UNIVERSITY OF NY UPSTATE MEDICAL UNIVERSITY
Graduated: 1995
NPI: 1528146347
Practice Locations (3)
1800 HARRISON ST, FL 7
OAKLAND, CA 946123463
PO BOX, SUITE 254869
SACRAMENTO, CA 968654869
PO BOX, SUITE 1870
WATSONVILLE, CA 950771870
Source: CMS National Downloadable File, September 2026.