Medical school: COLLEGE OF OSTEO MED OF THE PACIFIC AT POMONA
Graduated: 1983
NPI: 1588789218
Practice Locations (1)
SUPERCLINIC PROFESSIONALS MEDICAL CORP A CALIFORNIA CORPORATION
12134 VICTORY BLVD, SUITE C
NORTH HOLLYWOOD, CA 916063205
8187628702
Source: CMS National Downloadable File, September 2026.