MEDICARE: PROHEALTH PARTNERS, A MEDICAL GROUP, INC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician

General Provider Information

NPI Number	:	1477685436
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PROHEALTH PARTNERS, A MEDICAL GROUP, INC

Provider Business Mailing Address
First Line	:	3840 WOODRUFF AVE STE 202
Second Line	:
City	:	LONG BEACH
State	:	CA
Zip	:	90808-2149
Country	:	US
Telephone Number	:	562-296-5528
Fax Number	:	562-296-8770

Provider Business Practice Location Address
First Line	:	3840 WOODRUFF AVE STE 202
Second Line	:
City	:	LONG BEACH
State	:	CA
Zip	:	90808-2149
Country	:	US
Telephone Number	:	562-296-5528
Fax Number	:	562-296-8770

Authorized Official
Title or Position	:	PRESIDENT
Name	:	PETER FERRERA
Credential	:	MD
Telephone Number	:	562-299-5200

Provider Enumeration Date	:	03/12/2007
Last Update Date	:	12/13/2024

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