Graduated: 2005
NPI: 1417178542
Practice Locations (2)
SOUTHERN CALIFORNIA PERMANENTE MEDICAL GROUP
800 NEW LOS ANGELES AVE
MOORPARK, CA 930213585
8055300028
SOUTHERN CALIFORNIA PERMANENTE MEDICAL GROUP
5601 DE SOTO AVE
WOODLAND HILLS, CA 913676701
8187192000
Source: CMS National Downloadable File, September 2026.