PROHEALTH PARTNERS A MEDICAL GROUP INC (NPI# 1447382411) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1447382411 |
| Entity Type | Organization |
| Organization Name | PROHEALTH PARTNERS A MEDICAL GROUP INC |
| Practice Address |
300 Redondo Ave Long Beach CA 90814-2651 |
| Practice Telephone | 5624337496 |
| Practice Fax Number | 5629879206 |
| Mailing Telephone | 5624337496 |
| Mailing Fax Number | 5629879206 |
| Enumeration Date | 2007-03-12 |
| Last Update Date | 2018-10-04 |
| Authorized Official Name | BARRY STEVEN ALLSWANG (PRESIDENT) |
| Authorized Official Telephone | 5622995200 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207R00000X | Internal Medicine | Allopathic & Osteopathic Physicians | ||
| Y | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | BLUE SHIELD GROUP NUMBER | ZZZ47088Z | 01 |
| CA | GR0064153 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639613359 | Prohealth Partners A Medical Group Inc | Psychiatry & Neurology | 2900 Bristol St Ste B203, Costa Mesa, CA 92626-5948 | 2016-12-14 |
| 1962956094 | Prohealth Partners A Medical Group Inc | Internal Medicine | 1042 San Bernardino Rd, Upland, CA 91786-4921 | 2016-08-05 |
| 1619321791 | Prohealth Partners A Medical Group Inc | Psychiatry & Neurology | 16300 Sand Canyon Ave Ste 488, Irvine, CA 92618-3711 | 2016-04-14 |
| 1376905406 | Prohealth Partners A Medical Group Inc | Internal Medicine | 685 N 13th Ave Ste 7, Upland, CA 91786-4963 | 2016-03-28 |
| 1366857260 | Prohealth Partners A Medical Group Inc | Psychiatry & Neurology | 26800 Crown Valley Pkwy Ste 510, Mission Viejo, CA 92691-8028 | 2014-06-30 |
| 1326460023 | Prohealth Partners A Medical Group Inc | Internal Medicine | 101 E Beverly Blvd Ste 303, Montebello, CA 90640-4316 | 2014-01-14 |
| 1538292404 | Prohealth Partners A Medical Group Inc | Internal Medicine | 1220 Hemlock Way Ste 204, Santa Ana, CA 92707-3655 | 2007-03-13 |
| 1750816526 | Prohealth Partners A Medical Group Inc | Internal Medicine | 3816 Woodruff Ave Ste 411, Long Beach, CA 90808-2146 | 2017-04-28 |
| 1912432477 | Prohealth Partners A Medical Group Inc | Psychiatry & Neurology | 1 Hoag Dr, Newport Beach, CA 92663 | 2017-04-21 |
| 1356882435 | Prohealth Partners A Medical Group Inc | Obstetrics & Gynecology | 20911 Earl St Ste 180, Torrance, CA 90503-4353 | 2017-03-09 |
| Street Address |
300 REDONDO AVE |
| City | LONG BEACH |
| State | CA |
| Zip Code | 90814-2651 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710991757 | Deborah Ann Chow | Nurse Practitioner | 300 Redondo Ave, Long Beach, CA 90814-2651 | 2006-07-27 |
| 1033537493 | Tyler De Jong | Internal Medicine | 300 Redondo Ave, Long Beach, CA 90814-2651 | 2014-04-02 |
| 1861678443 | Lurline Pricer Nieto | Nurse Practitioner | 300 Redondo Ave, Long Beach, CA 90814-2651 | 2008-01-14 |
| 1093894750 | Judith Jennifer Belman | Nurse Practitioner | 300 Redondo Ave, Long Beach, CA 90814-2651 | 2006-11-03 |
| 1427062462 | Stephanie S Green | Family Medicine | 300 Redondo Ave, Long Beach, CA 90814-2651 | 2006-07-27 |
| 1790709186 | Perry R Koseff | Family Medicine | 300 Redondo Ave, Long Beach, CA 90814-2651 | 2006-07-27 |
| 1467466409 | Clayton B Dejong | Internal Medicine | 300 Redondo Ave, Long Beach, CA 90814-2651 | 2006-07-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164797056 | Recovery At Sea | Community/Behavioral Health | 2345 East 4th Street, Long Beach, CA 90814 | 2012-03-12 |
| 1982869616 | James R Gaither Jr. | Rehabilitation Practitioner | 2017 E 4th Street, Long Beach, CA 90814 | 2008-07-22 |
| 1760676274 | Charles Edward Criddle | Chiropractor | 352 Newport Ave, Long Beach, CA 90814 | 2007-08-29 |
| 1891911459 | Ting-wey Yen | Dentist | 319 Redondo Ave., Long Beach, CA 90814 | 2007-04-18 |
| 1194850495 | Donna Marie Camagay Calima | Dentist | 389 Redondo Ave, Long Beach, CA 90814 | 2007-02-23 |
| 1366595332 | Roger Justin Wood | Marriage & Family Therapist | 3424 E 4th St, Long Beach, CA 90814 | 2007-01-20 |
| 1467558338 | Rudy Steven Mendoza | Dentist | 392 Redondo Ave, Long Beach, CA 90814 | 2006-09-16 |
| 1578670766 | Seany Renfrow | Psychologist | 5170 Colorado, Long Beach, CA 90814 | 2006-08-24 |
| 1245210368 | Johnny L Triplett | Anesthesiology | 4674 East Barker Way, Long Beach, CA 90814 | 2006-01-17 |
| 1992960371 | Maria Veronica Uvero Racelis | Rehabilitation Practitioner | 2017 E 4th Street, Long Beach, CA 90814 | 2008-07-24 |
| Find all providers in zip 90814 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144852435 | Clnica Uriel / Iradj Nazarian Md | Family Medicine | 1187 E Anaheim St, Long Beach, CA 90813-3662 | 2020-02-05 |
| 1104485887 | Pmd Wellness Center Inc. | Family Medicine | Pmd Wellness Center Inc, 1187 E. Anaheim St., Long Beach, CA 90813-3663 | 2019-06-06 |
| 1699248674 | Central Neighborhood Health Foundat | Family Medicine | 711 E Via Wanda, Long Beach, CA 90805-6526 | 2019-01-02 |
| 1629580337 | Kathleen Legaspi Hoops | Family Medicine | 865 Lees Ave, Long Beach, CA 90815-5024 | 2017-11-02 |
| 1609222942 | Prohealth Partners A Medical Group | Family Medicine | 3816 Woodruff Ave Ste 406, Long Beach, CA 90808-2146 | 2016-05-05 |
| 1083079289 | Majestic Medical Clinic, Inc. | Family Medicine | 817 Atlantic Ave # 14, Long Beach, CA 90813-4512 | 2015-12-15 |
| 1336522788 | Duc Nguyen | Family Medicine | 555 E Ocean Blvd Ste 110, Long Beach, CA 90802 | 2015-07-02 |
| 1356781132 | Philip Kim | Family Medicine | 1729 Termino Ave Ste B, Long Beach, CA 90804-2121 | 2013-06-26 |
| 1881932168 | Ronald Merton Sommer | Family Medicine | 1436 W. 23rd St., Westside Free Clinic, Long Beach, CA 90810 | 2013-01-22 |
| 1053693275 | Michael James Miech | Family Medicine | 6301 Marina Pacifica Dr S, Long Beach, CA 90803-3821 | 2011-09-13 |
| Find all providers in LONG BEACH | ||||
| City | LONG BEACH |
| Zip Code | 90814 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.