Prospera Internal Medicine & Aesthetics, Inc.

Primary specialty

Health Service Clinic/CenterTaxonomy code 261QH0100X

Legal business name

PROSPERA INTERNAL MEDICINE & AESTHETICS, INC.

Practice address

4452 Park Blvd Ste 306
San Diego, CA 92116-4049

Phone

(619) 206-4232

Fax

(833) 972-5097

NPI assigned

May 24, 2024

Organization subpart

No

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

Authorized official

Name

Lea M Pace, PA-CNPI 1710211180

Title

Owner, Secretary

Phone

(619) 518-1061

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Lea Marie Pace, PA

  • Medical Physician Assistant
  • San Diego, CA
  • NPI 1710211180
  NPD Authorized official

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

{
    "created_epoch": "1716508800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1716508800000",
    "number": "1992545230",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4452 PARK BLVD STE 306",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921164049",
            "telephone_number": "619-206-4232",
            "fax_number": "833-972-5097"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4452 PARK BLVD STE 306",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921164049",
            "telephone_number": "619-206-4232",
            "fax_number": "833-972-5097"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROSPERA INTERNAL MEDICINE & AESTHETICS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-05-24",
        "last_updated": "2024-05-24",
        "certification_date": "2024-05-24",
        "status": "A",
        "authorized_official_last_name": "PACE",
        "authorized_official_first_name": "LEA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER, SECRETARY",
        "authorized_official_telephone_number": "619-518-1061",
        "authorized_official_credential": "PA-C"
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Yuliya Eduardovna Proosaselts, M.D.
• Shea Prophet
• Christopher Mancha Propps
• Proprius, Inc.
• Tobe Propst, MD
• Prosperity Home Care LLC
• Prosperous Health San Diego, LLC
• Heather Prosser, NP
• Alisa Prostek, B.A. SLPA
• Protocol Intelligence Inc.

• Health Service Clinic/Center in San Diego, CA
• Providers in San Diego, CA by specialty
• Health Service Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.