Provider Demographics
NPI:1427480987
Name:PROHEALTH PARTNERS A MEDICAL GROUP
Entity type:Organization
Organization Name:PROHEALTH PARTNERS A MEDICAL GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:BARRY
Authorized Official - Middle Name:STEVEN
Authorized Official - Last Name:ALLSWANG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:562-299-5200
Mailing Address - Street 1:5150 E PACIFIC COAST HWY
Mailing Address - Street 2:SUITE 500
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90804-3312
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1124 W CARSON ST
Practice Address - Street 2:
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90502-2006
Practice Address - Country:US
Practice Address - Phone:310-222-2773
Practice Address - Fax:310-782-9652
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-08-06
Last Update Date:2019-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Multi-Specialty
No207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Multi-Specialty
No208M00000XAllopathic & Osteopathic PhysiciansHospitalistGroup - Multi-Specialty