Medical school: UNIVERSITY OF CALIFORNIA, IRVINE, CALIFORNIA COLLEGE OF MEDICINE
Graduated: 1996
NPI: 1942200183
Practice Locations (2)
715 TANK FARM RD
San Luis Obispo, CA 934017068
715 TANK FARM RD
SAN LUIS OBISPO, CA 934017068
8055435577
Source: CMS National Downloadable File, September 2026.