Graduated: 1999
NPI: 1164441200
Practice Locations (2)
SOUTHERN CALIFORNIA PERMANENTE MEDICAL GROUP
3851 SHAW RIDGE RD
SAN DIEGO, CA 921302807
6195285000
SOUTHERN CALIFORNIA PERMANENTE MEDICAL GROUP
4647 ZION AVE
SAN DIEGO, CA 921202507
6195285000
Source: CMS National Downloadable File, September 2026.