NPIMap

Organization Active NPI

Progressive Medical Specialists

  • Methadone Clinic
  • San Diego, CA
National Provider Identifier
1457533747
Registry record updated Nov 29, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Methadone ClinicTaxonomy code 261QM2800X
License
37-19 Issued in CA
Legal business name
PROGRESSIVE MEDICAL SPECIALISTS
Practice address
4974 El Cajon Blvd
Suite a
San Diego, CA 92115-4677
Phone
(619) 286-4600
Fax
(619) 286-0060
NPI assigned
Nov 29, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 29, 2007

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

Authorized official

Name
Tim Boylan
Title
Director
Phone
(619) 286-4600

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Methadone Clinic 261QM2800X 37-19 CA Primary

Addresses

Primary practice location

4974 El Cajon Blvd
Suite a
San Diego, CA 92115-4677

Mailing address

4974 El Cajon Blvd
Suite a
San Diego, CA 92115-4677
Phone (619) 286-4600

National Provider Directory

National Provider Directory
Tax ID family
Progressive Medical Specialists2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1196294400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1196294400000",
    "number": "1457533747",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4974 EL CAJON BLVD",
            "address_2": "SUITE A",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921154677",
            "telephone_number": "619-286-4600",
            "fax_number": "619-286-0060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4974 EL CAJON BLVD",
            "address_2": "SUITE A",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921154677",
            "telephone_number": "619-286-4600",
            "fax_number": "619-286-0060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROGRESSIVE MEDICAL SPECIALISTS",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-29",
        "last_updated": "2007-11-29",
        "status": "A",
        "authorized_official_last_name": "BOYLAN",
        "authorized_official_first_name": "TIM",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "619-286-4600"
    },
    "taxonomies": [
        {
            "code": "261QM2800X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Methadone",
            "state": "CA",
            "license": "37-19",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2007; 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.