Medical school: TUFTS UNIVERSITY SCHOOL OF MEDICINE
Graduated: 1990
NPI: 1932138013
Practice Locations (2)
241 W OLIVE AVE
BURBANK, CA 915021825
8185631400
LAKESIDE MEDICAL ORGANIZATION A MEDICAL GROUP INC
1500 S CENTRAL AVE, SUITE 200
GLENDALE, CA 912043853
8182914010
Source: CMS National Downloadable File, September 2026.