Graduated: 2005
NPI: 1902069578
Practice Locations (2)
SOUTHERN CALIFORNIA PERMANENTE MEDICAL GROUP
9961 SIERRA AVE
FONTANA, CA 923356720
9094275000
SOUTHERN CALIFORNIA PERMANENTE MEDICAL GROUP
10850 ARROW RTE
RANCHO CUCAMONGA, CA 917304833
8887500036
Source: CMS National Downloadable File, September 2026.