Graduated: 2001
NPI: 1306115498
Practice Locations (2)
SOUTHERN CALIFORNIA PERMANENTE MEDICAL GROUP
43112 15TH ST W
LANCASTER, CA 935346219
6617262378
SOUTHERN CALIFORNIA PERMANENTE MEDICAL GROUP
13652 CANTARA ST
PANORAMA CITY, CA 914025423
8183752000
Source: CMS National Downloadable File, September 2026.