Medical school: SOUTHERN CALIFORNIA COLLEGE OF OPTOMETRY
Graduated: 1993
NPI: 1245307099
Practice Locations (2)
SOUTHERN CALIFORNIA PERMANENTE MEDICAL GROUP
9961 SIERRA AVE
FONTANA, CA 923356720
9094275000
SOUTHERN CALIFORNIA PERMANENTE MEDICAL GROUP
2295 S VINEYARD AVE
ONTARIO, CA 917617925
9097245000
Source: CMS National Downloadable File, September 2026.