Graduated: 1999
NPI: 1114094943
Practice Locations (2)
SOUTHERN CALIFORNIA PERMANENTE MEDICAL GROUP
2055 KELLOGG AVE
CORONA, CA 928793111
8669847483
SOUTHERN CALIFORNIA PERMANENTE MEDICAL GROUP
10800 MAGNOLIA AVE
RIVERSIDE, CA 925053043
9513532000
Source: CMS National Downloadable File, September 2026.