Medical school: SOUTHERN CALIFORNIA COLLEGE OF OPTOMETRY
Graduated: 1988
NPI: 1588741995
Practice Locations (3)
KAISER FOUNDATION HEALTH PLAN OF THE MID ATLANTIC STATES, INC
1221 MERCANTILE LN
LARGO, MD 207745374
3016185700
KAISER FOUNDATION HEALTH PLAN OF THE MID ATLANTIC STATES, INC
12255 FAIR LAKES PKWY
FAIRFAX, VA 220333952
7032374800
KAISER FOUNDATION HEALTH PLAN OF THE MID ATLANTIC STATES, INC
14139 POTOMAC MILLS RD
WOODBRIDGE, VA 221924644
7032573000
Source: CMS National Downloadable File, September 2026.