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The places are likely the same, but to say they are exact proximations is a bit much, especially since we don't know the exact time period in which the games take place. This could be the Year 5000 AD for all we know and humanity has stagnated or regressed at various points with technology and Pokemon present, along with wars.
Take a look at Kanto for instance, this is what Kanto actually is in relation to its real life locations. It's vastly bigger than anything we ever get to play and see, with considerable distance in between these places in reality. While you can still tell that it's obviously Kanto, you call into question how far apart said things are and your own interpretation of it. Every region is like that, granted it's less like that from Gen 6 onward (with the exception of Kitakami). In reality these places are absolutely massive and we're basically playing what an 11-14 year old envisions the map and world to be like. They have no car for Police Stations, Hospitals, etc. because it isn't on their mind, just as the distance isn't on their mind, Pewter and Viridian are close enough, so they must be right by each other. And if you don't want to go that way, clearly they aren't 1:1 or some cities have fallen or been abandoned over the years, or were never built in this Universe in the first place.
