Provider Demographics
NPI:1023164878
Name:PROGRESSIVE MOTION, INC.
Entity type:Organization
Organization Name:PROGRESSIVE MOTION, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:GLEN
Authorized Official - Middle Name:K
Authorized Official - Last Name:SUGAHARA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:310-465-1810
Mailing Address - Street 1:23862 HAWTHORNE BLVD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90505-8203
Mailing Address - Country:US
Mailing Address - Phone:310-465-1810
Mailing Address - Fax:
Practice Address - Street 1:23862 HAWTHORNE BLVD
Practice Address - Street 2:SUITE 100
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90505-8202
Practice Address - Country:US
Practice Address - Phone:310-465-1810
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-26
Last Update Date:2011-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA0829800001Medicare NSC