Registry details
Type
Individual
Primary specialty
Anesthesiology, Pain Medicine
Enumerated
Apr 1, 2015
License(s)
20A19239 (CA), 20A18239 (CA)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| MAILING | 10989 BLUFFSIDE DR APT 3106 | Studio City, CA 91604-4406 | 614-634-6377 |
| LOCATION | 222 W PUEBLO ST STE B | Santa Barbara, CA 93105-3805 | 805-563-0363 |
Watch this provider
Get a webhook/email the day this provider is added to the OIG-LEIE exclusion list or appears in an FDA enforcement action.