Medical school: UNIVERSITY OF CALIFORNIA, IRVINE, CALIFORNIA COLLEGE OF MEDICINE
Graduated: 2000
NPI: 1609871920
Practice Locations (1)
LAKESIDE MEDICAL ORGANIZATION A MEDICAL GROUP INC
12660 RIVERSIDE DR, SUITE 225
NORTH HOLLYWOOD, CA 916073469
8187550265
Source: CMS National Downloadable File, September 2026.