Graduated: 1990
NPI: 1699823591
Practice Locations (2)
SOUTHERN CALIFORNIA PERMANENTE MEDICAL GROUP
3875 AVOCADO BLVD
LA MESA, CA 919417303
6195285000
SOUTHERN CALIFORNIA PERMANENTE MEDICAL GROUP
4647 ZION AVE
SAN DIEGO, CA 921202507
6195285000
Source: CMS National Downloadable File, September 2026.