Graduated: 1987
NPI: 1356584015
Practice Locations (2)
SOUTHERN CALIFORNIA PERMANENTE MEDICAL GROUP
25825 VERMONT AVE
HARBOR CITY, CA 907103518
3103255111
SOUTHERN CALIFORNIA PERMANENTE MEDICAL GROUP
10800 MAGNOLIA AVE
RIVERSIDE, CA 925053043
9513532000
Source: CMS National Downloadable File, September 2026.