Graduated: 1992
NPI: 1164570065
Practice Locations (2)
SOUTHERN CALIFORNIA PERMANENTE MEDICAL GROUP
13652 CANTARA ST
PANORAMA CITY, CA 914025423
8183752000
SOUTHERN CALIFORNIA PERMANENTE MEDICAL GROUP
27107 TOURNEY RD
SANTA CLARITA, CA 913551860
6612222323
Source: CMS National Downloadable File, September 2026.