NPIMap

Organization Active NPI

Prohealth Partners a Medical Group Inc

  • Cardiovascular Disease Physician
  • Upland, CA
National Provider Identifier
1376905406
Registry record updated Dec 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
Legal business name
PROHEALTH PARTNERS A MEDICAL GROUP INC
Practice address
685 N 13TH Ave Ste 7
Upland, CA 91786-4963
Phone
(909) 981-8383
Fax
(909) 920-3054
NPI assigned
Mar 28, 2016
Last updated
Dec 2, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 2, 2021

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

Authorized official

Name
Barry S Allswang, MD
Title
President
Phone
(562) 299-5200

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RC0000X Primary

Addresses

Primary practice location

685 N 13TH Ave Ste 7
Upland, CA 91786-4963

Mailing address

685 N 13TH Ave Ste 7
Upland, CA 91786-4963

Other practice location 1

685 N 13th Ave Ste 9
Upland, CA 91786-4963
Phone (909) 981-8383

Other practice location 2

685 N 13th Ave Ste 1
Upland, CA 91786-4963
Phone (909) 981-8383

Other practice location 3

685 N 13th Ave Ste 10
Upland, CA 91786-4963
Phone (909) 981-8383

Other practice location 4

685 N 13th Ave Ste 2
Upland, CA 91786-4963
Phone (909) 981-8383

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
Tax ID family
Prohealth Partners Inc63 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 23

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 23

Locations

685 N 13th Ave
Upland, CA 91786
Phone (909) 500-8683

685 N 13th Ave
Ste 2
Upland, CA 91786
Phone (909) 500-8683

685 N 13th Ave
Ste 7
Upland, CA 91786
Phone (909) 981-8383

Networks

  • BSC 65 PLUS INDIVIDUAL MAPDPlans: Blue Shield 65 Plus (HMO) (H0504-015-000, H0504); Blue Shield 65 Plus (HMO) (H0504-039-000, H0504); Blue Shield 65 Plus Plan 2 (HMO) (H0504-021-000, H0504); Blue Shield Inspire (HMO) (H0504-041-000, H0504); Blue Shield 65 Plus (HMO) (H0504-038-000, H0504); Blue Shield Inspire (HMO) (H0504-047-000, H0504); Blue Shield 65 Plus (HMO) (H0504-026-000, H0504); Blue Shield Advantage (HMO) (H0504-050-000, H0504); Blue Shield AdvantageOptimum Plan (HMO) (H5928-004-000, H5928); Blue Shield Inspire (HMO) (H0504-043-000, H0504)…

Practitioners & affiliated clinicians

Practitioners 1

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": "1459123200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1638403200000",
    "number": "1376905406",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "685 N 13TH AVE STE 7",
            "city": "UPLAND",
            "state": "CA",
            "postal_code": "917864963"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "685 N 13TH AVE STE 7",
            "city": "UPLAND",
            "state": "CA",
            "postal_code": "917864963",
            "telephone_number": "909-981-8383",
            "fax_number": "909-920-3054"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "685 N 13th Ave Ste 9",
            "address_purpose": "LOCATION",
            "city": "Upland",
            "state": "CA",
            "postal_code": "917864963",
            "country_code": "US",
            "telephone_number": "909-981-8383",
            "fax_number": "909-920-3054",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "685 N 13th Ave Ste 1",
            "address_purpose": "LOCATION",
            "city": "Upland",
            "state": "CA",
            "postal_code": "917864963",
            "country_code": "US",
            "telephone_number": "909-981-8383",
            "fax_number": "909-920-0406",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "685 N 13th Ave Ste 10",
            "address_purpose": "LOCATION",
            "city": "Upland",
            "state": "CA",
            "postal_code": "917864963",
            "country_code": "US",
            "telephone_number": "909-981-8383",
            "fax_number": "909-920-3054",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "685 N 13th Ave Ste 2",
            "address_purpose": "LOCATION",
            "city": "Upland",
            "state": "CA",
            "postal_code": "917864963",
            "country_code": "US",
            "telephone_number": "909-981-8383",
            "fax_number": "909-920-3054",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "PROHEALTH PARTNERS A MEDICAL GROUP INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-03-28",
        "last_updated": "2021-12-02",
        "certification_date": "2021-12-02",
        "status": "A",
        "authorized_official_last_name": "ALLSWANG",
        "authorized_official_first_name": "BARRY",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "562-299-5200",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Upland, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2021; 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.