Graduated: 1999
NPI: 1992737597
Practice Locations (3)
11024 BALBOA BLVD, SUITE 204
GRANADA HILLS, CA 913445099
11024 BALBOA BLVD, SUITE 504
GRANADA HILLS, CA 913445007
11024 BALBOA BLVD, SUITE 504
GRANADA HILLS, CA 913446350
Source: CMS National Downloadable File, September 2026.