Graduated: 1996
NPI: 1992864623
Practice Locations (2)
SOUTHERN CALIFORNIA PERMANENTE MEDICAL GROUP
110 N LA BREA AVE
INGLEWOOD, CA 903011708
6104193310
SOUTHERN CALIFORNIA PERMANENTE MEDICAL GROUP
6041 CADILLAC AVE
LOS ANGELES, CA 900341702
8009548000
Source: CMS National Downloadable File, September 2026.