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NPI Code Detail

MEDICARE: PROGRESSIVE MEDICAL IMAGING, INC.

MEDICARE: PROGRESSIVE MEDICAL IMAGING, INC.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1246XS1301XSonography Specialist/Technologist Cardiovascular
22471S1302XSonography Radiologic Technologist

General Provider Information

NPI Number : 1063608669
Entity Type Code : Organization
Provider Name (Legal Business Name) : PROGRESSIVE MEDICAL IMAGING, INC.
Provider Business Mailing Address
First Line : 626 CAMINO DE ENCANTO
Second Line :
City : REDONDO BEACH
State : CA
Zip : 90277-6534
Country : US
Telephone Number : 323-658-8787
Fax Number : 323-658-8763
Provider Business Practice Location Address
First Line : 4302 OVERLAND AVE STE A
Second Line :
City : CULVER CITY
State : CA
Zip : 90230-4117
Country : US
Telephone Number : 323-658-8787
Fax Number : 323-658-8763
Authorized Official
Title or Position : PRESIDENT
Name : MR. FRANCIS HUI-BON-HOA
Credential : RDMS
Telephone Number : 323-658-8787
Provider Enumeration Date : 09/18/2007
Last Update Date : 06/12/2023

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