Graduated: 1988
NPI: 1811046295
Practice Locations (2)
SOUTHERN CALIFORNIA PERMANENTE MEDICAL GROUP
4647 ZION AVE
SAN DIEGO, CA 921202507
6195285000
SOUTHERN CALIFORNIA PERMANENTE MEDICAL GROUP
780 SHADOWRIDGE DR
VISTA, CA 920837986
6195285000
Source: CMS National Downloadable File, September 2026.