NPIMap

Organization Active NPI

Prohealth Partners, a Medical Group, Inc.

  • Nephrology Physician
  • Los Alamitos, CA
National Provider Identifier
1154952653
Registry record updated May 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
Legal business name
PROHEALTH PARTNERS, A MEDICAL GROUP, INC.
Practice address
3791 Katella Ave Ste 101
Los Alamitos, CA 90720-2000
Phone
(562) 446-0580
NPI assigned
Feb 3, 2020
Last updated
May 20, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 20, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Barry Steven Allswang
Title
President
Phone
(562) 491-9281

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X NU
Nephrology Physician 207RN0300X NU Primary

Addresses

Primary practice location

3791 Katella Ave Ste 101
Los Alamitos, CA 90720-2000

Mailing address

5150 E Pacific Coast Hwy Ste 500
Long Beach, CA 90804-3328
Phone (562) 299-5200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031211000927 CA Part B Supplier - Clinic/Group Practice 2769388412 Receives reassigned benefits from 296 practitioners
This NPI is an additional NPI on the enrollment

National Provider Directory

National Provider Directory

Locations

3661 Torrance Blvd
Ste 103
Torrance, CA 90503
Phone (310) 540-7240

Practitioners & affiliated clinicians

Practitioners 10

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1580688000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1653004800000",
    "number": "1154952653",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5150 E PACIFIC COAST HWY STE 500",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908043328",
            "telephone_number": "562-299-5200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3791 KATELLA AVE STE 101",
            "city": "LOS ALAMITOS",
            "state": "CA",
            "postal_code": "907202000",
            "telephone_number": "562-446-0580"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROHEALTH PARTNERS, A MEDICAL GROUP, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-02-03",
        "last_updated": "2022-05-20",
        "certification_date": "2022-05-20",
        "status": "A",
        "authorized_official_last_name": "ALLSWANG",
        "authorized_official_first_name": "BARRY",
        "authorized_official_middle_name": "STEVEN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "562-491-9281"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Alamitos, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.