Medical school: CHICAGO COLLEGE OF OSTEOPATHY
Graduated: 1999
NPI: 1861569865
Practice Locations (2)
SOUTHERN CALIFORNIA PERMANENTE MEDICAL GROUP
9961 SIERRA AVE
FONTANA, CA 923356720
9094275000
SOUTHERN CALIFORNIA PERMANENTE MEDICAL GROUP
1301 CALIFORNIA ST
REDLANDS, CA 923742910
9098093222
Source: CMS National Downloadable File, September 2026.