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PROHEALTH PARTNERS A MEDICAL GROUP
NPI 1497296404
Internal Medicine in Lakewood, CA

Active since March 10, 2017CLIA 05D2135136 · Waiver
3650 SOUTH ST STE 403, LAKEWOOD, CA 90712(562) 531-0377(562) 531-1724 Get Directions Write a Review

NPPES record last updated: September 26, 2022. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Sep 26, 2022, Apr 11, 2017 (2 updates tracked since 2017).

About Prohealth Partners A Medical Group NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PROHEALTH PARTNERS A MEDICAL GROUP (NPI 1497296404) is a healthcare organization registered as an internal medicine in Lakewood, California and active in the NPI registry since March 2017. The organization holds a CLIA Waiver certificate valid through August 14, 2027 and lists Barry S Allswang, President, as its authorized official.

NPPES Registry Identity

NPI1497296404
Entity TypeOrganization
Primary Taxonomy207R00000X
Legal Business NamePROHEALTH PARTNERS A MEDICAL GROUP
Location Address3650 SOUTH ST STE 403Lakewood, CA 90712-1504
Mailing Address3650 South St Ste 403Lakewood, CA 90712-1504 · (562) 531-0377
Phone(562) 531-0377
Fax(562) 531-1724
Organization SubpartNo
Authorized OfficialBarry S AllswangPresident · (562) 299-5200
Enumeration DateMarch 10, 2017
Last NPPES UpdateSeptember 26, 20222 updates tracked since enumeration
NPPES CertifiedSeptember 26, 2022
✔ NPI 1497296404 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
Definition
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
3650 SOUTH ST STE 403, Lakewood, CA 90712
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Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 05D2135136

Prohealth Partners A Medical Group Inc · Lakewood, CA
Active · expires Aug 14, 2027
CLIA Number05D2135136
Laboratory TypePhysician Office
Certificate Effective DateAugust 15, 2025
Certificate Expiration DateAugust 14, 2027
Laboratory DirectorJesse J. Licuanan
Laboratory Phone(562) 531-0377
Laboratory LocationProhealth Partners A Medical Group Inc3650 E South St Ste 403, Lakewood, CA 90712
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 4

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

COMPREHENSIVE WOMEN'S ANESTHESIA AND PAIN MANAGEMENT GROUP, INC.
Anesthesiology
3650 SOUTH ST STE 403
LAKEWOOD, CA 90712
Los Angeles County (562) 634-8812
JESSE JOSEPH LICUANAN M.D.
Internal Medicine
3650 SOUTH ST STE 403
LAKEWOOD, CA 90712
Los Angeles County (562) 531-0377
MIRIAM MACKOVIC-BASIC
Obstetrics & Gynecology
3650 SOUTH ST STE 403
LAKEWOOD, CA 90712
Los Angeles County (562) 634-8812
NEHA BHANSALI M.D
Internal Medicine
3650 SOUTH ST STE 403
LAKEWOOD, CA 90712
Los Angeles County (562) 531-0377

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Prohealth Partners A Medical Group's NPI number?

The NPI number for Prohealth Partners A Medical Group is 1497296404. It was assigned to this organization in the NPPES registry on March 10, 2017.

Where is Prohealth Partners A Medical Group located?

Prohealth Partners A Medical Group is located at 3650 South St Ste 403, Lakewood, CA 90712. The listed phone number is (562) 531-0377.

What is Prohealth Partners A Medical Group's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Does Prohealth Partners A Medical Group hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 05D2135136) is associated with this NPI, valid through August 14, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Prohealth Partners A Medical Group was last updated on September 26, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.