Graduated: 1990
NPI: 1114075025
Practice Locations (2)
SOUTHERN CALIFORNIA PERMANENTE MEDICAL GROUP
44444 20TH ST W
LANCASTER, CA 935342714
6619512826
SOUTHERN CALIFORNIA PERMANENTE MEDICAL GROUP
13652 CANTARA ST
PANORAMA CITY, CA 914025423
8183752000
Source: CMS National Downloadable File, September 2026.