Healthcare Provider Details

I. General information

NPI: 1669276200
Provider Name (Legal Business Name): PROHEALTH PARTNERS, A MEDICAL GROUP, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/02/2025
Last Update Date: 04/02/2025
Certification Date: 04/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8900 BOLSA AVE STE D
WESTMINSTER CA
92683-5475
US

IV. Provider business mailing address

8900 BOLSA AVE STE D
WESTMINSTER CA
92683-5475
US

V. Phone/Fax

Practice location:
  • Phone: 657-666-3125
  • Fax:
Mailing address:
  • Phone: 657-666-3125
  • 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: BARRY STEVEN ALLSWANG
Title or Position: PRESIDENT
Credential:
Phone: 562-299-5239