MEDICARE: PROHEALTH PARTNERS A MEDICAL GROUP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	207Q00000X	Family Medicine Physician
2	363A00000X	Physician Assistant
3	208000000X	Pediatrics Physician

General Provider Information

NPI Number	:	1033341680
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PROHEALTH PARTNERS A MEDICAL GROUP

Provider Business Mailing Address
First Line	:	5150 E PACIFIC COAST HWY STE 500
Second Line	:
City	:	LONG BEACH
State	:	CA
Zip	:	90804-3328
Country	:	US
Telephone Number	:	619-335-5259
Fax Number	:	619-872-2498

Provider Business Practice Location Address
First Line	:	5150 E PACIFIC COAST HWY STE 500
Second Line	:
City	:	LONG BEACH
State	:	CA
Zip	:	90804-3328
Country	:	US
Telephone Number	:	619-335-5259
Fax Number	:	619-872-2498

Authorized Official
Title or Position	:	PRESIDENT
Name	:	BARRY STEVEN ALLSWANG
Credential	:	MD
Telephone Number	:	562-299-5200

Provider Enumeration Date	:	08/17/2009
Last Update Date	:	01/11/2023

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