Graduated: 1999
NPI: 1558486084
Practice Locations (2)
SOUTHERN CALIFORNIA PERMANENTE MEDICAL GROUP
9961 SIERRA AVE
FONTANA, CA 923356720
9094275000
CALIFORNIA LUNA CARE PHYSICAL THERAPY PC
16185 LOS GATOS BLVD, SUITE 205
LOS GATOS, CA 950324569
8665253175
Source: CMS National Downloadable File, September 2026.