Graduated: 2008
NPI: 1154654069
Practice Locations (2)
SOUTHERN CALIFORNIA PERMANENTE MEDICAL GROUP
9961 SIERRA AVE
FONTANA, CA 923356720
9094275000
SOUTHERN CALIFORNIA PERMANENTE MEDICAL GROUP
325 W HOSPITALITY LN
SAN BERNARDINO, CA 924083243
8662053595
Source: CMS National Downloadable File, September 2026.