Healthcare Provider Details

I. General information

NPI: 1215481940
Provider Name (Legal Business Name): PROHEALTH PARTNERS, A MEDICAL GROUP, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/10/2016
Last Update Date: 12/02/2025
Certification Date: 12/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10861 CHERRY ST STE 105
LOS ALAMITOS CA
90720-5403
US

IV. Provider business mailing address

6261 KATELLA AVE STE 200
CYPRESS CA
90630-5249
US

V. Phone/Fax

Practice location:
  • Phone: 562-259-8881
  • Fax:
Mailing address:
  • Phone: 562-299-5200
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

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