STEPHEN G. PROVONSHA

RIVERSIDE, CA
NPI1598836413
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy208D00000X General Practice
(Licence: CA  G51217)
Enumeration Date2006-11-13
Last Update Date2021-11-30
Business Address
STEPHEN G. PROVONSHA MD
10800 MAGNOLIA AVE
RIVERSIDE, CA 92505-3043
Phone number: 909-353-2000
Mailing Address
STEPHEN G. PROVONSHA MD
10800 MAGNOLIA AVE
RIVERSIDE, CA 92505-3043
Phone number: 909-353-2000
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