Prohealth Partners, a Medical Group, Inc.
Organization Active NPI Family Medicine Physician · Westminster, CA
NPI 1669276200 · NPPES record last updated Apr 2, 2025
Key facts
- NPI
- 1669276200
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Family Medicine Physician 207Q00000X
- Legal business name
- PROHEALTH PARTNERS, A MEDICAL GROUP, INC.
- Practice address
- 8900 Bolsa Ave Ste D
Westminster, CA 92683-5475 - Phone
- (657) 666-3125
- NPI assigned
- Apr 2, 2025
- Organization subpart
- Yes
- Parent organization (as reported)
- PROHEALTH PARTNERS, A MEDICAL GROUP, INC.
Authorized official
- Name
- Barry Steven Allswang
- Title
- President
- Phone
- (562) 299-5239
Corporate family (same tax ID) 24
Practitioners 1
-
Huy Duc Lam, MD
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 05D2326891 | Prohealth Partners a Medical Group Inc | Certificate of waiver | Jul 10, 2027 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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
- Tax ID family
- Prohealth Partners a M
- Part of
- Prohealth Partners a M
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician |
207Q00000X | Yes |
Addresses
Primary practice location
8900 Bolsa Ave Ste D
Westminster, CA 92683-5475
Mailing address
8900 Bolsa Ave Ste D
Westminster, CA 92683-5475
Phone (657) 666-3125
Other providers in Westminster, CA
- Precision Diagnostic Laboratory, Inc
- Preston Le Chiropractic, Inc.
- Russell Preza
- Priority Science Labs
- Professional RX Inc
- Pulmonary Disease Services
- Natalie Pung
- Pure Path Recovery
- Nathan Puskas
- Q Pharmacy Inc
All providers in Westminster, CA · Family Medicine Physician in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 2, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.