Graduated: 2012
NPI: 1861871162
Practice Locations (4)
393 E WALNUT ST
PASADEN, CA 911880001
393 E WALNUT ST FL, 5 PHR GROUP PROVIDER ENROLLMENT UNIT
Pasadena, CA 911880001
PHR GROUP PROVIDER ENROLLMENT UNIT
PASADENA, CA 911880001
393 E WALNUT 3RD FL
PASEDENA, CA 911880001
Source: CMS National Downloadable File, September 2026.