Graduated: 1996
NPI: 1629137294
Practice Locations (2)
SOUTHERN CALIFORNIA PERMANENTE MEDICAL GROUP
6041 CADILLAC AVE
LOS ANGELES, CA 900341702
8009548000
SOUTHERN CALIFORNIA PERMANENTE MEDICAL GROUP
1450 10TH ST
SANTA MONICA, CA 904012857
3103198200
Source: CMS National Downloadable File, September 2026.