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General NPI Number Information
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NPI Number | 1760767347
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Entity Type | Organization
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Legal Business Name | PROGRESSIVE MEDICAL GROUP INC
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Dates
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Enumeration Date | 10/14/2011
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Last Update Date | 10/14/2011
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Provider Practice Location Address
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Address Line | 3251 W 6TH ST SUITE 410
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City | LOS ANGELES
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State | CA
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Zip | 90020-5023
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Country | US
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Telephone | 213-388-0182
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Fax | 213-388-2847
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Provider Business Mailing Address
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Address Line | 3251 W 6TH ST SUITE 410
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City | LOS ANGELES
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State | CA
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Zip | 90020-5023
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Country | US
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Telephone | 213-388-0182
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Fax | 213-388-2847
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Authorized Official
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Title or Position | CEO
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Name | RITA ELAINE STARRITT
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Credential | M.D.
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Telephone | 213-388-0182
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number |
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License Number State |
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