Medical school: MEDICAL COLLEGE OF WISCONSIN
Graduated: 1999
NPI: 1013952001
Practice Locations (3)
SOUTHERN CALIFORNIA PERMANENTE MEDICAL GROUP
27300 IRIS AVE
MORENO VALLEY, CA 925554802
9512430811
SOUTHERN CALIFORNIA PERMANENTE MEDICAL GROUP
27350 IRIS AVE
MORENO VALLEY, CA 925554802
8669847483
SOUTHERN CALIFORNIA PERMANENTE MEDICAL GROUP
10800 MAGNOLIA AVE
RIVERSIDE, CA 925053043
9513532000
Source: CMS National Downloadable File, September 2026.