Graduated: 2014
NPI: 1417335621
Practice Locations (2)
SOUTHERN CALIFORNIA PERMANENTE MEDICAL GROUP
9961 SIERRA AVE
FONTANA, CA 923356720
9094275000
SOUTHERN CALIFORNIA PERMANENTE MEDICAL GROUP
27320 W LUGONIA AVE
REDLANDS, CA 923742041
9093071602
Source: CMS National Downloadable File, September 2026.