Medical school: STATE UNIVERSITY OF NY UPSTATE MEDICAL UNIVERSITY
Graduated: 1995
NPI: 1275685075
Practice Locations (2)
PERMANENTE MEDICAL GROUP INC
700 LAWRENCE EXPY
SANTA CLARA, CA 950515173
4088511000
PERMANENTE MEDICAL GROUP INC
710 LAWRENCE EXPRESS WAY
SANTA CLARA, CA 950515173
4088511000
Source: CMS National Downloadable File, September 2026.