Graduated: 1990
NPI: 1790722718
Practice Locations (2)
1520 W KETTLEMAN LN, SUITE B
LODI, CA 952429290
2093393797
TEAM PHYSICIANS OF CALIFORNIA MEDICAL GROUP INC
975 S FAIRMONT AVE
LODI, CA 952405118
2093343411
Source: CMS National Downloadable File, September 2026.