Medical school: UNIVERSITY OF ILLINOIS COLLEGE OF MED (CHI/PEOR/ROCK/CHM-URB)
Graduated: 1999
NPI: 1578641288
Practice Locations (1)
PERMANENTE MEDICAL GROUP INC
7373 W LANE
STOCKTON, CA 952103377
2094762000
Source: CMS National Downloadable File, September 2026.