Graduated: 2011
NPI: 1790069078
Practice Locations (5)
1051 NEWPORT AVE, APT 4
LONG BEACH, CA 908048678
PO BOX, SUITE 451249
LOS ANGELES, CA 90045
402 W BROADWAY, SUITE 400
SAN DIEGO, CA 921013554
6203 SAN IGNACIO AVE, SUITE 110
SAN JOSE, CA 951191371
66 E FLAGLER ST
MIAMI, FL 331301807
Source: CMS National Downloadable File, September 2026.