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	207RI0011X	Interventional Cardiology Physician
2	207RC0000X	Cardiovascular Disease Physician

General Provider Information

NPI Number	:	1538292404
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PROHEALTH PARTNERS A MEDICAL GROUP INC

Provider Business Mailing Address
First Line	:	1220 HEMLOCK WAY STE 204
Second Line	:
City	:	SANTA ANA
State	:	CA
Zip	:	92707-3655
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1220 HEMLOCK WAY STE 204
Second Line	:
City	:	SANTA ANA
State	:	CA
Zip	:	92707-3655
Country	:	US
Telephone Number	:	714-617-2626
Fax Number	:	714-422-0362

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

Provider Enumeration Date	:	03/13/2007
Last Update Date	:	01/30/2026

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