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Family Medicine Physician

NPI: 1770044174IndividualAccepts Medicare

Specialties, Licenses & Credentials

Family Medicine PhysicianPrimary

Family Medicine

Code: 207Q00000X

125.073753(IL)125073753(IL)A180365(CA)

CMS Specialties

PrimaryFAMILY PRACTICE

Education

UNIVERSITY OF ILLINOIS COLLEGE OF MED (CHI/PEOR/ROCK/CHM-URB)

Class of 2017

Contact & Hours

Address
4560 ADMIRALTY WAY STE 100
MARINA DEL REY, CA 90292

Quick Facts

NPI
1770044174
Entity Type
Individual
Gender
Male
Medicare
Accepted
Specialties
3
Locations
1
Years in Practice
9

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