Most Relevant Information
Provider Data
| NPI Number: | 1003048026 |
| Provider Name: | BRETT ALLEN PROVENCE D.O. |
| Entity Type: | Individual |
| Taxonomy Code: | 208M00000X |
| Specialty: | Hospitalist |
| License Number: | 20A11220 |
Most Important Dates
| Enumeration Date: | 08/10/2009 |
| Last Updated: | 12/01/2021 |
Provider Practice Location
1011 BALDWIN PARK BLVD
4 EAST HOSPITALIST OFFICE
BALDWIN PARK
CA
917065806
Practice Location Phone/Fax
| Phone: | 6268511011 |
| Fax: |
Provider Mailing Location
1011 BALDWIN PARK BLVD
4 EAST HOSPITALIST OFFICE
BALDWIN PARK
CA
917065806
Provider Mailing Phone/Fax
| Phone: | 6268511011 |
| Fax: |