Healthcare Provider Details

I. General information

NPI: 1679414437
Provider Name (Legal Business Name): PROHEALTH PARTNERS A MEDICAL GROUP INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/03/2026
Last Update Date: 04/03/2026
Certification Date: 04/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

416 S MYRTLE AVE
MONROVIA CA
91016-2812
US

IV. Provider business mailing address

6261 KATELLA AVE STE 200 STE 200
CYPRESS CA
90630-5249
US

V. Phone/Fax

Practice location:
  • Phone: 626-357-3296
  • Fax: 626-359-5608
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: FERRERA PETER
Title or Position: PRESIDENT
Credential: MD
Phone: 562-299-5200