Graduated: 2024
NPI: 1902634462
Practice Locations (2)
SOUTHERN CALIFORNIA PERMANENTE MEDICAL GROUP
25825 VERMONT AVE
HARBOR CITY, CA 907103518
3103255111
CALIFORNIA STATE UNIVERSITY LONG BEACH
1250 N BELLFLOWER BLVD, KIN 105
LONG BEACH, CA 908404704
5629858286
Source: CMS National Downloadable File, September 2026.