Graduated: 2010
NPI: 1619252517
Practice Locations (2)
SOUTHERN CALIFORNIA PERMANENTE MEDICAL GROUP
17296 SLOVER AVE
FONTANA, CA 923377585
9094275000
SOUTHERN CALIFORNIA PERMANENTE MEDICAL GROUP
9961 SIERRA AVE
FONTANA, CA 923356720
9094275000
Source: CMS National Downloadable File, September 2026.