Stephen G. Provonsha, MD
Stephen G. Provonsha, MD is a General Practice Physician in Riverside, California. Licensed in California. Registered with an NPI since 2006.
- Licensed in
- CA
- In the registry since
- 2006
What do these letters mean?
- MD — Doctor of Medicine
- A physician who completed allopathic medical school.
Practice location Address checks out
10800 Magnolia AveRiverside, CA 92505-3043
Phone: (909) 353-2000
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| General Practice Physician (primary) | Taxonomy 208D00000X · Licence G51217 (CA) |
|---|
Record details
| NPI number | 1598836413 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Male |
| Credentials | MD |
| Sole proprietor | No |
| NPI enumerated | November 13, 2006 |
| Last updated in NPPES | November 30, 2021 |
| Mailing address | 10800 Magnolia Ave, Riverside, CA 92505-3043 |
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