Graduated: 1994
NPI: 1174671002
Practice Locations (5)
SOUTHERN CALIFORNIA PERMANENTE MEDICAL GROUP
9961 SIERRA AVE
FONTANA, CA 923356720
9094275000
FACULTY PHYSICIANS AND SURGEONS OF LLUSM
11370 ANDERSON ST
LOMA LINDA, CA 923543450
FACULTY PHYSICIANS AND SURGEONS OF LLUSM
FILE NUMBER, SUITE 54701
LOS ANGELES, CA 900744701
SOUTHERN CALIFORNIA PERMANENTE MEDICAL GROUP
2295 S VINEYARD AVE
ONTARIO, CA 917617925
9097245000
FACULTY PHYSICIANS AND SURGEONS OF LLUSM
26780 BARTON RD
REDLANDS, CA 923734308
9095585174
Source: CMS National Downloadable File, September 2026.