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Active Life, Llc
Prosthetic/Orthotic Supplier in West Covina, California
NPI 1568961977

Active Life, Llc is a Prosthetic/Orthotic Supplier based in Glendale, CA. Active Life, Llc practices in West Covina, CA. The NPI Number for Active Life, Llc is 1568961977 and holds a License No. (California).

The current practice location address for Active Life, Llc is 1135 S Sunset Ave Ste 302, West Covina, CA and can be reached out via phone at 626-727-6455 and via fax at 626-360-3220.

Location: 1135 S Sunset Ave Ste 302, West Covina, CA, 91206-4741
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1568961977
Provider Name
Active Life, Llc
Credential
Provider Entity Type
Organization
Address
1135 S Sunset Ave Ste 302, West Covina, CA, 91206-4741
Phone Number
626-727-6455
Fax Number
626-360-3220
Provider Enumeration Date
02/12/2018
Last Update Date
03/10/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
XC0009601 05 CA
institution
Provider Business Practice Location Address Details
Address
1135 S Sunset Ave Ste 302
City
West Covina
State
California
Zip
91790-3964
Phone Number
626-727-6455
Fax Number
626-360-3220
person
Provider Business Mailing Address Details
Address
1135 S Sunset Ave Ste 302
City
West Covina
State
California
Zip
91790-3964
Phone Number
626-727-6455
Fax Number
626-360-3220
person
Provider's Taxonomy Details 1
Type
Suppliers
Classification
Prosthetic/Orthotic Supplier
Speciality
-
Taxonomy
335E00000X
License No.
()
Definition
An organization that provides prosthetic and orthotic care which may include, but is not limited to, patient evaluation, prosthesis or orthosis design, fabrication, fitting and modification to treat limb loss for purposes of restoring physiological function and/or cosmesis or to treat a neuromusculoskeletal disorder or acquired condition.
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