Provider Demographics
NPI:1548225964
Name:STARRITT, RITA (MD)
Entity Type:Individual
Prefix:MRS
First Name:RITA
Middle Name:
Last Name:STARRITT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5721 LA JOLLA HERMOSA AVE
Mailing Address - Street 2:ATTN PROGRESSIVE MEDICAL GROUP
Mailing Address - City:LA JOLLA
Mailing Address - State:CA
Mailing Address - Zip Code:92037-7330
Mailing Address - Country:US
Mailing Address - Phone:303-586-1200
Mailing Address - Fax:888-419-0054
Practice Address - Street 1:1333 CAMINO DEL RIO S
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92108-3520
Practice Address - Country:US
Practice Address - Phone:303-399-0365
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-19
Last Update Date:2019-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO34886207R00000X, 208M00000X, 208M00000X
CAC54648207R00000X
NV14540207R00000X
UT8288854207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
COG24468Medicare UPIN
COC85691Medicare ID - Type UnspecifiedMDCR