Graduated: 2025
NPI: 1912739749
Practice Locations (4)
16400 VENTURA BLVD, SUITE 323
ENCINO, CA 914362160
4453 FIRMAMENT AVE
ENCINO, CA 914363104
12913 HARBOR BLVD, SUITE Q3
GARDEN GROVE, CA 928405855
9420 NOBILE AVE, UNIT 112
NORTH HILLS, CA 913437824
Source: CMS National Downloadable File, September 2026.