NPIMap

Organization Active NPI

Progressive Radiology Services

  • Radiology Clinic/Center
  • San Rafael, CA
National Provider Identifier
1124296439
Registry record updated Feb 20, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiology Clinic/CenterTaxonomy code 261QR0200X
Legal business name
PROGRESSIVE RADIOLOGY SERVICES
Practice address
4144 Redwood Hwy
Suite B
San Rafael, CA 94903-2646
Phone
(415) 479-9907
NPI assigned
Feb 20, 2008
Organization subpart
Yes
Parent organization
PROGRESSIVE RADIOLOGY SERVICESAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 20, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Sonja Moelleken, M.D.
Title
Medical Director
Phone
(415) 321-4682

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Radiology Clinic/Center 261QR0200X Primary

Addresses

Primary practice location

4144 Redwood Hwy
Suite B
San Rafael, CA 94903-2646

Mailing address

1201 Marina Village Pkwy
Suite 301
Alameda, CA 94501-1087
Phone (510) 865-9670

National Provider Directory

National Provider Directory
Tax ID family
Progressive Radiology Services5 organizations share this tax ID, including this one
Part of
Progressive Radiology Services

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1203465600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1203465600000",
    "number": "1124296439",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1201 MARINA VILLAGE PKWY",
            "address_2": "SUITE 301",
            "city": "ALAMEDA",
            "state": "CA",
            "postal_code": "945011087",
            "telephone_number": "510-865-9670"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4144 REDWOOD HWY",
            "address_2": "SUITE B",
            "city": "SAN RAFAEL",
            "state": "CA",
            "postal_code": "949032646",
            "telephone_number": "415-479-9907"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROGRESSIVE RADIOLOGY SERVICES",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PROGRESSIVE RADIOLOGY SERVICES",
        "enumeration_date": "2008-02-20",
        "last_updated": "2008-02-20",
        "status": "A",
        "authorized_official_last_name": "MOELLEKEN",
        "authorized_official_first_name": "SONJA",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "415-321-4682",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QR0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Rafael, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.