MEDICARE: PROACTIVE WORK HEALTH MEDICAL CENTER INC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	261QP2000X	Physical Therapy Clinic/Center
2	261QP2300X	Primary Care Clinic/Center
3	261QU0200X	Urgent Care Clinic/Center
4	261QX0100X	Occupational Medicine Clinic/Center
5	261QM1300X	Multi-Specialty Clinic/Center

General Provider Information

NPI Number	:	1336260421
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PROACTIVE WORK HEALTH MEDICAL CENTER INC

Provider Business Mailing Address
First Line	:	1230 W 3RD ST
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90017-1408
Country	:	US
Telephone Number	:	213-977-9300
Fax Number	:	213-977-9600

Provider Business Practice Location Address
First Line	:	1230 W 3RD ST
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90017-1408
Country	:	US
Telephone Number	:	213-977-9300
Fax Number	:	213-977-9600

Authorized Official
Title or Position	:	PRESIDENT
Name	:	STEPHEN R GREENE
Credential	:	M.D.
Telephone Number	:	213-977-9300

Provider Enumeration Date	:	04/03/2007
Last Update Date	:	09/11/2025

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Directions to “PROACTIVE WORK HEALTH MEDICAL CENTER INC ” Practice Location

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