Graduated: 1999
NPI: 1740212356
Practice Locations (3)
18044 SAN FERNANDO MISSION BLVD
Granada Hills, CA 913444044
11024 BALBOA BLVD, SUITE 504
GRANADA HILLS, CA 913445099
18044 SAN FERNANDO MISSION BLVD
GRANADA HILLS, CA 913444044
Source: CMS National Downloadable File, September 2026.