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General NPI Number Information
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NPI Number | 1669276200
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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 | 04/02/2025
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Last Update Date | 04/02/2025
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Provider Practice Location Address
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Address Line | 8900 BOLSA AVE STE D
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City | WESTMINSTER
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State | CA
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Zip | 92683-5475
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Country | US
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Telephone | 657-666-3125
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Fax |
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Provider Business Mailing Address
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Address Line | 8900 BOLSA AVE STE D
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City | WESTMINSTER
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State | CA
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Zip | 92683-5475
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Country | US
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Telephone | 657-666-3125
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | BARRY STEVEN ALLSWANG
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Credential |
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Telephone | 562-299-5239
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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