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1003048026
BRETT ALLEN PROVENCE
BALDWIN PARK, CA
NPI
1003048026
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
208M00000X Hospitalist
(Licence: CA 20A11220)
Enumeration Date
2009-08-10
Last Update Date
2021-12-01
Business Address
-- BRETT ALLEN PROVENCE D.O.
1011 BALDWIN PARK BLVD 4 EAST HOSPITALIST OFFICE
BALDWIN PARK, CA 91706-5806
Phone number: 626-851-1011
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Mailing Address
-- BRETT ALLEN PROVENCE D.O.
1011 BALDWIN PARK BLVD 4 EAST HOSPITALIST OFFICE
BALDWIN PARK, CA 91706-5806
Phone number: 626-851-1011
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