Medical school: EASTERN VIRGINIA MEDICAL SCHOOL
Graduated: 1998
NPI: 1659459238
Practice Locations (2)
PERMANENTE MEDICAL GROUP INC
99 MONTECILLO RD
SAN RAFAEL, CA 949033308
4154442000
PERMANENTE MEDICAL GROUP INC
975 SERENO DR
VALLEJO, CA 945892441
7076511000
Source: CMS National Downloadable File, September 2026.