Medical school: MEDICAL COLLEGE OF WISCONSIN
Graduated: 1990
NPI: 1669549549
Practice Locations (3)
SOUTHERN CALIFORNIA PERMANENTE MEDICAL GROUP
13652 CANTARA ST
PANORAMA CITY, CA 914025423
8183752000
SOUTHERN CALIFORNIA PERMANENTE MEDICAL GROUP
27107 TOURNEY RD
SANTA CLARITA, CA 913551860
6612222323
MENDOCINO COMMUNITY HEALTH CLINIC INC
333 LAWS AVE
UKIAH, CA 954826540
7074681010
Source: CMS National Downloadable File, September 2026.