Organization
SOUTHERN CALIFORNIA PERMANENTE MEDICAL GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KHANG NGUYEN (DIRECTOR)
(626) 405-6942
Entity
Organization
Contact information
Practice address
17284 SLOVER AVE STE 205, FONTANA, CA 92337-7584
(626) 405-6942
Mailing address
17284 SLOVER AVE STE 205, FONTANA, CA 92337-7584
(626) 405-6942
Taxonomy
Speciality
Code
Description
License number
State
302R00000X
Health Maintenance Organization
Primary
—
—
Other
Enumeration date
06/29/2021
Last updated
06/29/2021
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