Graduated: 2002
NPI: 1922119734
Practice Locations (2)
NORTHEAST VALLEY HEALTH CORPORATION
12756 VAN NUYS BLVD
PACOIMA, CA 913311626
8188960531
NORTHEAST VALLEY HEALTH CORPORATION
14624 SHERMAN WAY, FL 6
VAN NUYS, CA 914052241
8189886335
Source: CMS National Downloadable File, September 2026.