Graduated: 2011
NPI: 1386157667
Practice Locations (2)
SOUTHERN CALIFORNIA PERMANENTE MEDICAL GROUP
10800 MAGNOLIA AVE
RIVERSIDE, CA 925053043
9513532000
SUD SPECIALTY GROUP - CA
4633 OLD IRONSIDES DR, SUITE 304
SANTA CLARA, CA 950541846
8662800260
Source: CMS National Downloadable File, September 2026.