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Joseph Johnny Provenzano JR., DO
Family Medicine Physician in Modesto, California
NPI 1215993738

Joseph Johnny Provenzano JR. is a Family Medicine Physician based in Sacramento, CA. Joseph Johnny Provenzano JR. practices in Modesto, CA and has the professional credentials of DO. The NPI Number for Joseph Johnny Provenzano JR. is 1215993738 and holds a License No. 20A5427 (California).

The current practice location address for Joseph Johnny Provenzano JR. is 3612 Dale Rd, Modesto, CA and can be reached out via phone at 209-522-0146.

Location: 3612 Dale Rd, Modesto, CA, 95827-2539
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1215993738
Provider Name
Joseph Johnny Provenzano JR.
Credential
DO
Provider Entity Type
Individual
Gender
Male
Address
3612 Dale Rd, Modesto, CA, 95827-2539
Phone Number
209-522-0146
Fax Number
Provider Enumeration Date
04/24/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
00AX54270 05 CA
institution
Provider Business Practice Location Address Details
Address
3612 Dale Rd
City
Modesto
State
California
Zip
95356-0500
Phone Number
209-522-0146
Fax Number
person
Provider Business Mailing Address Details
Address
3612 Dale Rd
City
Modesto
State
California
Zip
95356-0500
Phone Number
209-522-0146
Fax Number
person
Provider's Taxonomy Details 1
Type
Allopathic & Osteopathic Physicians
Classification
Family Medicine
Speciality
-
Taxonomy
207Q00000X
License No.
20A5427 (California)
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
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