Graduated: 2021
NPI: 1396470175
Practice Locations (2)
SOUTHERN CALIFORNIA PERMANENTE MEDICAL GROUP
4733 W SUNSET BLVD
LOS ANGELES, CA 900276021
2136674784
PROVIDENCE FACEY MEDICAL FOUNDATION
11333 SEPULVEDA BLVD
MISSION HILLS, CA 913451116
8183659531
Source: CMS National Downloadable File, September 2026.