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1265503239
MICHAEL S. PROVENGHI
ANAHEIM, CA
NPI
1265503239
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
207Q00000X Family Medicine
(Licence: CA A86795)
Enumeration Date
2006-11-13
Last Update Date
2021-12-01
Business Address
MICHAEL S. PROVENGHI MD
441 N LAKEVIEW AVE
ANAHEIM, CA 92807-3028
Phone number: 888-988-2800
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Mailing Address
MICHAEL S. PROVENGHI MD
441 N LAKEVIEW AVE
ANAHEIM, CA 92807-3028
Phone number: 888-988-2800
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