Medical school: STATE UNIVERSITY OF NEW YORK AT STONY BROOK, SCHOOL OF MEDICINE
Graduated: 1994
NPI: 1740338706
Practice Locations (2)
SOUTHERN CALIFORNIA PERMANENTE MEDICAL GROUP
4405 VANDEVER AVE
SAN DIEGO, CA 921203315
6195166606
SOUTHERN CALIFORNIA PERMANENTE MEDICAL GROUP
4647 ZION AVE
SAN DIEGO, CA 921202507
6195285000
Source: CMS National Downloadable File, September 2026.