Graduated: 2012
NPI: 1548641103
Practice Locations (3)
5302 S GRAMERCY PL
Los Angeles, CA 900622652
PO BOX, SUITE 451249
LOS ANGELES, CA 90045
1041 E YORBA LINDA BLVD, SUITE 202
Placentia, CA 928703760
Source: CMS National Downloadable File, September 2026.