Healthcare Provider Details

I. General information

NPI: 1760124499
Provider Name (Legal Business Name): PROHEALTH PARTNERS A MEDICAL GROUP INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/12/2022
Last Update Date: 08/14/2026
Certification Date: 08/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4281 KATELLA AVE STE 121
LOS ALAMITOS CA
90720-3593
US

IV. Provider business mailing address

4281 KATELLA AVE STE 121
LOS ALAMITOS CA
90720-3593
US

V. Phone/Fax

Practice location:
  • Phone: 562-437-6213
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

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