Medical school: CALIFORNIA SCHOOL OF PODIATRIC MEDICINE
Graduated: 2003
NPI: 1962580530
Practice Locations (2)
PERMANENTE MEDICAL GROUP INC
401 BICENTENNIAL WAY
SANTA ROSA, CA 954032149
7073934000
PERMANENTE MEDICAL GROUP INC
7373 W LANE
STOCKTON, CA 952103377
2094762000
Source: CMS National Downloadable File, September 2026.