Graduated: 1998
NPI: 1245307008
Practice Locations (2)
SOUTHERN CALIFORNIA PERMANENTE MEDICAL GROUP
9961 SIERRA AVE
FONTANA, CA 923356720
9094275000
SOUTHERN CALIFORNIA PERMANENTE MEDICAL GROUP
9550 ESCONDIDO AVE
HESPERIA, CA 923459120
8335742273
Source: CMS National Downloadable File, September 2026.