Carol Joy Provan, | |
2710 Middlefield Rd, Redwood City, CA 94063-3404 | |
(650) 573-2222 | |
Not Available |
Full Name | Carol Joy Provan |
---|---|
Gender | Female |
Speciality | Pediatrics |
Location | 2710 Middlefield Rd, Redwood City, California |
Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
Identifier | Type | State | Issuer |
---|---|---|---|
1780736041 | NPI | - | NPPES |
00A255990 | Medicaid | CA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
208000000X | Pediatrics | A25599 (California) | Primary |
Mailing Address | Practice Location Address |
---|---|
Carol Joy Provan, 2710 Middlefield Rd, Fair Oaks Childrens Clinic, Redwood City, CA 94063 Ph: (650) 573-2222 | Carol Joy Provan, 2710 Middlefield Rd, Redwood City, CA 94063-3404 Ph: (650) 573-2222 |
Danny Linggonegoro, Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 450 Broadway St Fl C2, Redwood City, CA 94063 Phone: 650-721-7190 | |
Thomas E. Sipes, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 1150 Veterans Blvd, Redwood City, CA 94063 Phone: 650-299-2000 | |
Jean Chi-hee Rhim, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 1150 Veterans Blvd, Redwood City, CA 94063 Phone: 650-299-2000 | |
Dr. Gina Lucy Rodriguez, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 77 Birch St Ste B, Redwood City, CA 94062 Phone: 650-363-6161 Fax: 650-363-9311 | |
Roma Hitesh Shah, DO Pediatrics Medicare: Medicare Enrolled Practice Location: 801 Brewster Ave Ste 175, Redwood City, CA 94063 Phone: 650-216-7794 | |
Leslie Sue, D.O. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 801 Brewster Ave Ste 175, Redwood City, CA 94063 Phone: 650-216-7794 Fax: 650-216-7796 | |
Gizella Sheila Laksana, M.D. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 2710 Middlefield Rd, Redwood City, CA 94063 Phone: 650-578-7141 Fax: 650-298-6881 |