Graduated: 1998
NPI: 1164548327
Practice Locations (2)
SOUTHERN CALIFORNIA PERMANENTE MEDICAL GROUP
4405 VANDEVER AVE
SAN DIEGO, CA 921203315
6195166606
SOUTHERN CALIFORNIA PERMANENTE MEDICAL GROUP
4647 ZION AVE
SAN DIEGO, CA 921202507
6195285000
Source: CMS National Downloadable File, September 2026.