Graduated: 2015
NPI: 1861854846
Practice Locations (2)
SOUTHERN CALIFORNIA PERMANENTE MEDICAL GROUP
9310 SIERRA AVE
FONTANA, CA 923355711
8662053595
SOUTHERN CALIFORNIA PERMANENTE MEDICAL GROUP
4647 ZION AVE
SAN DIEGO, CA 921202507
6195285000
Source: CMS National Downloadable File, September 2026.