Medical school: ILLINOIS COLLEGE OF OPTOMETRY AT CHICAGO
Graduated: 2003
NPI: 1770812935
Practice Locations (2)
SOUTHERN CALIFORNIA PERMANENTE MEDICAL GROUP
20000 RINALDI ST
PORTER RANCH, CA 913264900
8776080044
SOUTHERN CALIFORNIA PERMANENTE MEDICAL GROUP
5601 DE SOTO AVE
WOODLAND HILLS, CA 913676701
8187192000
Source: CMS National Downloadable File, September 2026.