Medical school: ILLINOIS COLLEGE OF OPTOMETRY AT CHICAGO
Graduated: 2004
NPI: 1720138373
Practice Locations (2)
SOUTHERN CALIFORNIA PERMANENTE MEDICAL GROUP
13652 CANTARA ST
PANORAMA CITY, CA 914025423
8183752000
SOUTHERN CALIFORNIA PERMANENTE MEDICAL GROUP
8250 WOODMAN AVE
PANORAMA CITY, CA 914025427
8183752000
Source: CMS National Downloadable File, September 2026.