Basic Information
| Provider Information | |||||||||
| NPI: | 1326379926 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | ARMT MEDICAL SPECIALISTS, INC | ||||||||
| LastName: | |||||||||
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| OtherOrganizationName: | PROGRESSIVE MEDICAL SPECIALISTS INC | ||||||||
| OtherOrganizationType: | 4 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4974 EL CAJON BLVD | ||||||||
| Address2: | SUITE A | ||||||||
| City: | SAN DIEGO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 921154654 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6192864600 | ||||||||
| FaxNumber: | 6192860060 | ||||||||
| Practice Location | |||||||||
| Address1: | 4974 EL CAJON BLVD | ||||||||
| Address2: | SUITE A | ||||||||
| City: | SAN DIEGO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 921154654 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6192864600 | ||||||||
| FaxNumber: | 6192860060 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/21/2010 | ||||||||
| LastUpdateDate: | 10/30/2020 | ||||||||
| NPIDeactivationReasonCode: | |||||||||
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| AuthorizedOfficialLastName: | O'ROURKE | ||||||||
| AuthorizedOfficialFirstName: | CHRISTOPHER | ||||||||
| AuthorizedOfficialMiddleName: | BLAKE | ||||||||
| AuthorizedOfficialTitleorPosition: | PROGRAM DIRECTOR | ||||||||
| AuthorizedOfficialTelephone: | 6192864600 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| NPICertificationDate: | 10/30/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QM2800X | 37-19 | CA | Y | Ambulatory Health Care Facilities | Clinic/Center | Methadone Clinic |
No ID Information.