Medical school: RUTGERS R W JOHNSON MEDICAL SCHOOL (CAM/NEW BRUNS/PISC)
Graduated: 2004
NPI: 1144454604
Practice Locations (1)
SOUTHERN CALIFORNIA PERMANENTE MEDICAL GROUP
9961 SIERRA AVE
FONTANA, CA 923356720
9094275000
Source: CMS National Downloadable File, September 2026.