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Organization
PROGENY PSYCHIATRIC CLINIC A MEDICAL CORPORATION
Active
Organization
PROGENY PSYCHIATRIC CLINIC A MEDICAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JASON P KELLOGG MD (CEO)
(949) 722-7118
Entity
Organization
Contact information
Practice address
17782 COWAN STE A, IRVINE, CA 92614-6041
(949) 722-7118
(949) 396-0965
Mailing address
17782 COWAN STE A, IRVINE, CA 92614-6041
(949) 722-7118
(949) 396-0965
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
2084N0400X
Neurology Physician
—
—
2084P0800X
Psychiatry Physician
Primary
—
—
Other
Enumeration date
10/09/2018
Last updated
08/08/2019
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