Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Michael S. Provenghi, MD

Individual provider Family Medicine Physician · NPI 1265503239

Michael S. Provenghi, MD is a Family Practice in Anaheim, California. Graduated from New York Medical College in 2002, 24 years ago. Practices with Southern California Permanente Medical Group, an 11,242-clinician group and accepts Medicare assignment. Licensed in California.

Years since qualifying
24
Trained at
New York Medical College
Licensed in
CA
In the registry since
2006
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

441 N Lakeview Ave
Anaheim, CA 92807-3028
Phone: (888) 988-2800
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X · Licence A86795 (CA)

Record details

NPI number1265503239
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedNovember 13, 2006
Last updated in NPPESDecember 1, 2021
Mailing address441 N Lakeview Ave, Anaheim, CA 92807-3028

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyFAMILY PRACTICE
Medical schoolNEW YORK MEDICAL COLLEGE
Graduated 2002 (24 years in practice)
Group practice Southern California Permanente Medical Group — 11242 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations4 on file with Medicare

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