Graduated: 2016
NPI: 1497139661
Practice Locations (2)
SOUTHERN CALIFORNIA PERMANENTE MEDICAL GROUP
9961 SIERRA AVE
FONTANA, CA 923356720
9094275000
SOUTHERN CALIFORNIA PERMANENTE MEDICAL GROUP
5330 SAN BERNARDINO ST
MONTCLAIR, CA 917632952
9093993700
Source: CMS National Downloadable File, September 2026.