Provider Demographics
NPI:1336641992
Name:PROHEALTH PARTNERS A MEDICAL GROUP
Entity Type:Organization
Organization Name:PROHEALTH PARTNERS A MEDICAL GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:BARRY
Authorized Official - Middle Name:STEVEN
Authorized Official - Last Name:ALLSWANG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:562-299-5200
Mailing Address - Street 1:26700 TOWNE CENTRE DR STE 165
Mailing Address - Street 2:
Mailing Address - City:FOOTHILL RANCH
Mailing Address - State:CA
Mailing Address - Zip Code:92610-2845
Mailing Address - Country:US
Mailing Address - Phone:949-519-0020
Mailing Address - Fax:949-519-0040
Practice Address - Street 1:26700 TOWNE CENTRE DR STE 165
Practice Address - Street 2:
Practice Address - City:FOOTHILL RANCH
Practice Address - State:CA
Practice Address - Zip Code:92610-2845
Practice Address - Country:US
Practice Address - Phone:949-519-0020
Practice Address - Fax:949-519-0040
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-02-28
Last Update Date:2019-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatologyGroup - Multi-Specialty