Graduated: 1986
NPI: 1912483165
Practice Locations (2)
COUNTY OF LOS ANGELES
11833 WILMINGTON AVE
LOS ANGELES, CA 900593015
3235688100
LOS ANGELES COUNTY DEPARTMENT OF PUBLIC HEALTH
11833 WILMINGTON AVE
LOS ANGELES, CA 900593015
3235688100
Source: CMS National Downloadable File, September 2026.