Graduated: 1979
NPI: 1972563765
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.