Individual
BRETT ALLEN PROVENCE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
1011 BALDWIN PARK BLVD, 4 EAST HOSPITALIST OFFICE, BALDWIN PARK, CA 91706-5806
(626) 851-1011
Mailing address
1011 BALDWIN PARK BLVD, 4 EAST HOSPITALIST OFFICE, BALDWIN PARK, CA 91706-5806
(626) 851-1011
Taxonomy
Speciality
Code
Description
License number
State
208M00000X
Hospitalist Physician
Primary
20A11220
CA
Other
Enumeration date
08/10/2009
Last updated
12/01/2021
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