Provider Type Icon

PROHEALTH PARTNERS A MEDICAL GROUP INC. NPI 1114050218


NPI Information

NPI: 1114050218
Provider Name: PROHEALTH PARTNERS, A MEDICAL GROUP, INC.
Classification: Family Medicine - 207Q00000X
Entity Type: Organization

CLIA Number: 05D0554537

Address:
911 E SAN ANTONIO DR STE 1
LONG BEACH, CA
ZIP 90807
Phone: (562) 728-8700
Get Directions

PROHEALTH PARTNERS, A MEDICAL GROUP, INC. is a family medicine in Long Beach, CA. The provider is 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. PROHEALTH PARTNERS, A MEDICAL GROUP, INC. NPI is 1114050218. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

911 E SAN ANTONIO DR STE 1
LONG BEACH, CA
ZIP 90807-204
Phone: (562) 728-8700
Fax: (562) 728-5855

The provider's authorized official is Barry Allswang .
The authorized official title is President and has the following contact phone number (562) 299-5200.

The CLIA number assigned to this NPI record is 05D0554537 - physician office with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 3/14/2007 and was last updated on 1/31/2018.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207Q00000XFamily MedicineYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1GR006415ZMEDICAIDCALIFORNIA
2ZZZ66256ZOTHERCALIFORNIABLUE SHIELD GROUP NUMBER

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.