Graduated: 1996
NPI: 1710184288
Practice Locations (3)
COUNTY OF SANTA CLARA
2101 ALEXIAN DR
SAN JOSE, CA 951161901
4082726050
COUNTY OF SANTA CLARA
751 S BASCOM AVE
SAN JOSE, CA 951282604
4088855000
COUNTY OF SANTA CLARA
751 S BASCOM AVE, SANTA CLARA VLY MED
SAN JOSE, CA 951282604
4088855000
Source: CMS National Downloadable File, September 2026.