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NPI Code Detail

MEDICARE: PROHEALTH PARTNERS A MEDICAL GROUP INC

MEDICARE: PROHEALTH PARTNERS A MEDICAL GROUP INC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207RS0012XSleep Medicine (Internal Medicine) Physician
2207R00000XInternal Medicine Physician
3208600000XSurgery Physician
42086S0129XVascular Surgery Physician
5207VF0040XUrogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician
62088F0040XUrogynecology and Reconstructive Pelvic Surgery (Urology) Physician
7208VP0000XPain Medicine Physician
8208800000XUrology Physician
9261QA1903XAmbulatory Surgical Clinic/Center
102088P0231XPediatric Urology Physician
11208M00000XHospitalist Physician

General Provider Information

NPI Number : 1104215151
Entity Type Code : Organization
Provider Name (Legal Business Name) : PROHEALTH PARTNERS A MEDICAL GROUP INC
Provider Business Mailing Address
First Line : 6261 KATELLA AVE STE 200
Second Line :
City : CYPRESS
State : CA
Zip : 90630-5249
Country : US
Telephone Number : 562-299-5200
Fax Number :
Provider Business Practice Location Address
First Line : 2801 ATLANTIC AVE
Second Line :
City : LONG BEACH
State : CA
Zip : 90806-1701
Country : US
Telephone Number : 562-299-5239
Fax Number :
Authorized Official
Title or Position : PRESIDENT
Name : PETER FERRERA
Credential : MD
Telephone Number : 562-299-5200
Provider Enumeration Date : 01/14/2015
Last Update Date : 12/12/2025

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Directions to “PROHEALTH PARTNERS A MEDICAL GROUP INC ” Practice Location

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