Graduated: 2016
NPI: 1790165843
Practice Locations (2)
PERMANENTE MEDICAL GROUP INC
939 ELLIS ST
SAN FRANCISCO, CA 941097714
4158332292
SUD SPECIALTY GROUP - CA
4633 OLD IRONSIDES DR, SUITE 304
SANTA CLARA, CA 950541846
8662800260
Source: CMS National Downloadable File, September 2026.