Graduated: 2008
NPI: 1881170199
Practice Locations (2)
LAKESIDE MEDICAL ORGANIZATION A MEDICAL GROUP INC
191 S BUENA VISTA ST, SUITE 150
BURBANK, CA 915054522
8182955920
WELLNESS MOBILE CLINIC
21241 VENTURA BLVD, SUITE 259
WOODLAND HILLS, CA 913642186
3238999450
Source: CMS National Downloadable File, September 2026.