Graduated: 2022
NPI: 1659012136
Practice Locations (8)
1902 WRIGHT PL, SUITE 200
CARLSBAD, CA 920086583
1064 GROVER AVE
GLENDALE, CA 912012402
FILE NUMBER, SUITE 54701
Los Angeles, CA 900744701
FILE NUMBER, SUITE 54701
LOS ANGELES, CA 900744701
PO BOX, SUITE 6644
PASADENA, CA 91109
39000 BOB HOPE DR
RANCHO MIRAGE, CA 922703235
4535 DRESSIER RD NW
CANTON, OH 447182545
2791 HOPPER WAY, APT 312
COLUMBUS, OH 432284353
Source: CMS National Downloadable File, September 2026.