| Organization Name: | PROGRESSIVE HEALTH SERVICES |
| NPI Number: | 1104074459 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | SUZANN A. GAGE (PRESIDENT AND EXECUTIVE DIRECTOR) |
| Mailing Address: | 2141 El Cajon Blvd San Diego |
| State: | CA US |
| Postal Code: | 921041101 |
| Phone Number: | 6192600810 |
| Fax Number: | 6194970719 |
| NPI Enumeration Date: | 08/28/2008 |
| NPI Last Update Date: | 10/15/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | C51231 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | CA |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |