Graduated: 2003
NPI: 1285944272
Practice Locations (2)
SOUTHERN CALIFORNIA PERMANENTE MEDICAL GROUP
12001 W WASHINGTON BLVD
LOS ANGELES, CA 900665801
3109154410
SOUTHERN CALIFORNIA PERMANENTE MEDICAL GROUP
6041 CADILLAC AVE
LOS ANGELES, CA 900341702
8009548000
Source: CMS National Downloadable File, September 2026.