Graduated: 1996
NPI: 1104975580
Practice Locations (2)
SOUTHERN CALIFORNIA PERMANENTE MEDICAL GROUP
4647 ZION AVE
SAN DIEGO, CA 921202507
6195285000
SOUTHERN CALIFORNIA PERMANENTE MEDICAL GROUP
6911 CONVOY CT
SAN DIEGO, CA 921111014
8585731504
Source: CMS National Downloadable File, September 2026.