Graduated: 2011
NPI: 1073194932
Practice Locations (2)
SOUTHERN CALIFORNIA PERMANENTE MEDICAL GROUP
5971 VENICE BLVD
LOS ANGELES, CA 900341713
8009548000
SOUTHERN CALIFORNIA PERMANENTE MEDICAL GROUP
6041 CADILLAC AVE
LOS ANGELES, CA 900341702
8009548000
Source: CMS National Downloadable File, September 2026.