Healthcare Provider Details

I. General information

NPI: 1700919669
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: 09/04/2025
Certification Date: 09/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1043 ELM AVE SUITE 300
LONG BEACH CA
90813-3271
US

IV. Provider business mailing address

1040 ELM AVE STE 200
LONG BEACH CA
90813-3266
US

V. Phone/Fax

Practice location:
  • Phone: 562-624-4999
  • Fax: 562-491-9128
Mailing address:
  • Phone: 562-624-4999
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License Number
License Number State

VIII. Authorized Official

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