Provider Demographics
NPI:1104284249
Name:PRO HEALTH SYSTEM INC
Entity type:Organization
Organization Name:PRO HEALTH SYSTEM INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:ARTOON
Authorized Official - Middle Name:
Authorized Official - Last Name:ARAKEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:888-663-2821
Mailing Address - Street 1:3579 E FOOTHILL BLVD
Mailing Address - Street 2:SUITE 614
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91107-3119
Mailing Address - Country:US
Mailing Address - Phone:888-663-2821
Mailing Address - Fax:323-375-5114
Practice Address - Street 1:1300 N VERMONT AVE
Practice Address - Street 2:1008
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90027-6005
Practice Address - Country:US
Practice Address - Phone:888-663-2821
Practice Address - Fax:323-375-5114
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-03
Last Update Date:2016-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty