Graduated: 2004
NPI: 1003158585
Practice Locations (2)
SOUTHERN CALIFORNIA PERMANENTE MEDICAL GROUP
3750 GRAND AVE
CHINO, CA 917105478
8887500036
SOUTHERN CALIFORNIA PERMANENTE MEDICAL GROUP
9961 SIERRA AVE
FONTANA, CA 923356720
9094275000
Source: CMS National Downloadable File, September 2026.