Graduated: 2006
NPI: 1083807580
Practice Locations (2)
SOUTHERN CALIFORNIA PERMANENTE MEDICAL GROUP
145 HODENCAMP RD
THOUSAND OAKS, CA 913605810
8885153500
SOUTHERN CALIFORNIA PERMANENTE MEDICAL GROUP
5601 DE SOTO AVE
WOODLAND HILLS, CA 913676701
8187192000
Source: CMS National Downloadable File, September 2026.