NPIMap

Organization Active NPI

Prohealth Partners a Medical Group

  • Internal Medicine Physician
  • Lakewood, CA
National Provider Identifier
1497296404
Registry record updated Sep 26, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
PROHEALTH PARTNERS A MEDICAL GROUP
Practice address
3650 South St Ste 403
Lakewood, CA 90712-1504
Phone
(562) 531-0377
Fax
(562) 531-1724
NPI assigned
Mar 10, 2017
Last updated
Sep 26, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 26, 2022

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
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

3650 South St Ste 403
Lakewood, CA 90712-1504

Mailing address

3650 South St Ste 403
Lakewood, CA 90712-1504
Phone (562) 531-0377

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 24

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

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1489104000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1664150400000",
    "number": "1497296404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3650 SOUTH ST STE 403",
            "city": "LAKEWOOD",
            "state": "CA",
            "postal_code": "907121504",
            "telephone_number": "562-531-0377"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3650 SOUTH ST STE 403",
            "city": "LAKEWOOD",
            "state": "CA",
            "postal_code": "907121504",
            "telephone_number": "562-531-0377",
            "fax_number": "562-531-1724"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROHEALTH PARTNERS A MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-03-10",
        "last_updated": "2022-09-26",
        "certification_date": "2022-09-26",
        "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": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakewood, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 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.