NPIMap

Organization Active NPI

Prohealth Partners a Medical Group

  • Internal Medicine Physician
  • Long Beach, CA
National Provider Identifier
1558030635
Registry record updated Sep 10, 2021
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
1777 N Bellflower Blvd Ste 101
Long Beach, CA 90815-4019
Phone
(562) 986-6138
Fax
(562) 986-6382
NPI assigned
Sep 10, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 10, 2021

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

Authorized official

Name
Barry Steven Allswang, MD
Title
Coo
Phone
(562) 299-5239

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

1777 N Bellflower Blvd Ste 101
Long Beach, CA 90815-4019

Mailing address

1777 N Bellflower Blvd Ste 101
Long Beach, CA 90815-4019
Phone (562) 986-6138

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 a M63 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": "1631232000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1631232000000",
    "number": "1558030635",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1777 N BELLFLOWER BLVD STE 101",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908154019",
            "telephone_number": "562-986-6138",
            "fax_number": "562-986-6382"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1777 N BELLFLOWER BLVD STE 101",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908154019",
            "telephone_number": "562-986-6138",
            "fax_number": "562-986-6382"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROHEALTH PARTNERS A MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-09-10",
        "last_updated": "2021-09-10",
        "certification_date": "2021-08-26",
        "status": "A",
        "authorized_official_last_name": "ALLSWANG",
        "authorized_official_first_name": "BARRY",
        "authorized_official_middle_name": "STEVEN",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "562-299-5239",
        "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 Long Beach, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 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.