Graduated: 2006
NPI: 1548344948
Practice Locations (2)
CLINIC SERVICES OF CALIFORNIA MEDICAL GROUP INC
1235 W VINE ST, SUITE 20
LODI, CA 952405144
2093343411
PERMANENTE MEDICAL GROUP INC
7373 W LANE
STOCKTON, CA 952103377
2094762000
Source: CMS National Downloadable File, September 2026.