Organization Active NPI

Prohealth Partners a Medical Group

  • Internal Medicine Physician
  • South Gate, CA
National Provider Identifier
1700457504
Registry record updated Jul 15, 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
3224 Santa Ana St
South Gate, CA 90280-2306
Phone
(323) 567-2384
NPI assigned
Jul 2, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 15, 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

3224 Santa Ana St
South Gate, CA 90280-2306

Mailing address

3224 Santa Ana St
South Gate, CA 90280-2306
Phone (323) 567-2384

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

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
05D2266993Prohealth Partners, a Medical Group, Inc3224 Santa Ana St, South Gate, CA 90280Certificate of waiverAug 17, 2026

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1625184000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1626307200000",
    "number": "1700457504",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3224 SANTA ANA ST",
            "city": "SOUTH GATE",
            "state": "CA",
            "postal_code": "902802306",
            "telephone_number": "323-567-2384"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3224 SANTA ANA ST",
            "city": "SOUTH GATE",
            "state": "CA",
            "postal_code": "902802306",
            "telephone_number": "323-567-2384"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROHEALTH PARTNERS A MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-07-02",
        "last_updated": "2021-07-15",
        "certification_date": "2021-07-15",
        "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 South Gate, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.