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Organization
SERGEY SERGEYEVICH PROGUSHEV MD INC
Active
Organization
SERGEY SERGEYEVICH PROGUSHEV MD INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SERGEY SERGEYEVICH PROGUSHEV MD (PRESIDENT)
(912) 658-1150
Entity
Organization
Contact information
Practice address
18330 ROSCOE BLVD, NORTHRIDGE, CA 91325-4105
(747) 224-4004
Mailing address
686 MONTEREY PL, SIERRA MADRE, CA 91024-2105
(912) 658-1150
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
—
—
207L00000X
Anesthesiology Physician
Primary
—
—
207LC0200X
Critical Care Medicine (Anesthesiology) Physician
—
—
Other
Enumeration date
11/08/2024
Last updated
11/08/2024
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