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General NPI Number Information
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NPI Number | 1104215151
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Entity Type | Organization
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Legal Business Name | PROHEALTH PARTNERS A MEDICAL GROUP INC
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Dates
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Enumeration Date | 01/14/2015
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Last Update Date | 12/12/2025
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Provider Practice Location Address
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Address Line | 2801 ATLANTIC AVE
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City | LONG BEACH
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State | CA
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Zip | 90806-1701
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Country | US
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Telephone | 562-299-5239
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Fax |
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Provider Business Mailing Address
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Address Line | 6261 KATELLA AVE STE 200
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City | CYPRESS
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State | CA
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Zip | 90630-5249
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Country | US
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Telephone | 562-299-5200
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | PETER FERRERA
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Credential | MD
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Telephone | 562-299-5200
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RS0012X
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Taxonomy Name | Sleep Medicine (Internal Medicine) Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 2086S0129X
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Taxonomy Name | Vascular Surgery Physician
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 207VF0040X
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Taxonomy Name | Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 2088F0040X
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Taxonomy Name | Urogynecology and Reconstructive Pelvic Surgery (Urology) Physician
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 208VP0000X
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Taxonomy Name | Pain Medicine Physician
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License Number |
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License Number State |
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Taxonomy #8
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Taxonomy Code | 208800000X
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Taxonomy Name | Urology Physician
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License Number |
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License Number State |
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Taxonomy #9
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Taxonomy Code | 261QA1903X
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Taxonomy Name | Ambulatory Surgical Clinic/Center
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License Number |
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License Number State |
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Taxonomy #10
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Taxonomy Code | 2088P0231X
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Taxonomy Name | Pediatric Urology Physician
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License Number |
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License Number State |
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Taxonomy #11
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number |
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License Number State |
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