Search › California › 103T00000X
Augustine Provencio, MS
NPI 1629810270 · on the registry since 2024 · sole proprietor
Practice
- Address
- 4650 W Sunset Blvd # 53
Los Angeles, CA 90027 - Phone
- (323) 361-3849
- Clinicians at this address
- 152
Registry record
- Primary taxonomy
- 103T00000X
103T00000X
- Also registered as
- 103TC2200X
- Sex
- Male
- Record last updated
- 2025-08-27
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in California