Southern California Permanente Medical Group
NPI #1316463763 in Fontana, California
Provider Information
- NPI Number
- 1316463763
- Entity Type
- Organization
- Organization Name
- Southern California Permanente Medical Group
- Primary Specialty
- Health Maintenance Organization
- Enumeration Date
- Aug 17, 2017
- Last Updated
- Nov 2, 2021
Practice Location
- Address
- 15272 SUMMIT AVE
- City
- Fontana
- State
- California
- ZIP Code
- 92336-0231
- Phone
- (877) 608-0044
Authorized Official
- Name
- RAMIN DAVIDOFF, MD
- Title
- EXECUTIVE MEDICAL DIRECTOR
- Phone
- (877) 608-0044
Specialties & Taxonomy Codes
| Specialty |
|---|
| Health Maintenance Organization |
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