Healthcare Provider Details

I. General information

NPI: 1093848509
Provider Name (Legal Business Name): PROHEALTH PARTNERS A MEDICAL GROUP INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/13/2007
Last Update Date: 12/12/2025
Certification Date: 12/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5750 DOWNEY AVE SUITE 100
LAKEWOOD CA
90712-1405
US

IV. Provider business mailing address

6261 KATELLA AVE STE 200
CYPRESS CA
90630-5249
US

V. Phone/Fax

Practice location:
  • Phone: 562-630-3105
  • Fax: 562-630-3853
Mailing address:
  • Phone: 562-299-5200
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: PETER FERRERA
Title or Position: PRESIDENT
Credential: MD
Phone: 562-299-5200