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General NPI Number Information
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NPI Number | 1124527395
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Entity Type | Organization
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Legal Business Name | PROGRESSIVE SLEEP MEDICINE, LLC.
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Dates
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Enumeration Date | 02/02/2018
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Last Update Date | 08/13/2020
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Provider Practice Location Address
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Address Line | 4234 RIVERWALK PKWY STE 280
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City | RIVERSIDE
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State | CA
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Zip | 92505-3370
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Country | US
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Telephone | 951-785-7190
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Fax | 951-688-7246
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Provider Business Mailing Address
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Address Line | 4234 RIVERWALK PKWY STE 280
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City | RIVERSIDE
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State | CA
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Zip | 92505-3370
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Country | US
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Telephone | 951-785-7190
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Fax | 951-688-7246
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | JESSICA R DOMINGUEZ
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Credential |
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Telephone | 951-785-7190
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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