Medical school: MEDICAL UNIVERSITY OF SOUTH CAROLINA COLLEGE OF MEDICINE
Graduated: 1990
NPI: 1679630446
Practice Locations (2)
110 JENSEN CT, SUITE 1B
THOUSAND OAKS, CA 913607484
8052300030
ACUTE CARE SURGERY MEDICAL GROUP INC
215 W JANSS RD
THOUSAND OAKS, CA 913601847
8054972727
Source: CMS National Downloadable File, September 2026.