Graduated: 1994
NPI: 1992417893
Practice Locations (2)
FACULTY PHYSICIANS AND SURGEONS OF LLUSM
11370 ANDERSON ST
LOMA LINDA, CA 923543450
FACULTY PHYSICIANS AND SURGEONS OF LLUSM
FILE NUMBER, SUITE 54701
LOS ANGELES, CA 900744701
Source: CMS National Downloadable File, September 2026.