Graduated: 2020
NPI: 1891369153
Practice Locations (2)
SOUTHERN CALIFORNIA PERMANENTE MEDICAL GROUP
9961 SIERRA AVE
FONTANA, CA 923356720
9094275000
SOUTHERN CALIFORNIA PERMANENTE MEDICAL GROUP
4647 ZION AVE
SAN DIEGO, CA 921202507
6195285000
Source: CMS National Downloadable File, September 2026.