Graduated: 2022
NPI: 1871295030
Practice Locations (3)
1109 W NEWGROVE ST
LANCASTER, CA 935343311
402 W BROADWAY, SUITE 400
SAN DIEGO, CA 921013554
18425 BURBANK BLVD, SUITE 609
TARZANA, CA 913562826
Source: CMS National Downloadable File, September 2026.