Graduated: 2025
NPI: 1982076477
Practice Locations (2)
SOUTHERN CALIFORNIA PERMANENTE MEDICAL GROUP
4647 ZION AVE
SAN DIEGO, CA 921202507
6195285000
SUD SPECIALTY GROUP - CA
4633 OLD IRONSIDES DR, SUITE 304
SANTA CLARA, CA 950541846
8662800260
Source: CMS National Downloadable File, September 2026.