Graduated: 1975
NPI: 1538217468
Practice Locations (2)
SOUTHERN CALIFORNIA PERMANENTE MEDICAL GROUP
44105 15TH ST W
LANCASTER, CA 935344088
6617295512
SOUTHERN CALIFORNIA PERMANENTE MEDICAL GROUP
13652 CANTARA ST
PANORAMA CITY, CA 914025423
8183752000
Source: CMS National Downloadable File, September 2026.