Provider Demographics
NPI:1760767347
Name:PROGRESSIVE MEDICAL GROUP INC
Entity Type:Organization
Organization Name:PROGRESSIVE MEDICAL GROUP INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:RITA
Authorized Official - Middle Name:ELAINE
Authorized Official - Last Name:STARRITT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:213-388-0182
Mailing Address - Street 1:3251 W 6TH ST
Mailing Address - Street 2:SUITE 410
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90020-5023
Mailing Address - Country:US
Mailing Address - Phone:213-388-0182
Mailing Address - Fax:213-388-2847
Practice Address - Street 1:3251 W 6TH ST
Practice Address - Street 2:SUITE 410
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90020-5023
Practice Address - Country:US
Practice Address - Phone:213-388-0182
Practice Address - Fax:213-388-2847
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-10-14
Last Update Date:2011-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Multi-Specialty