institution
Active Life, Llc
Prosthetic/Orthotic Supplier in San Diego, California
NPI 1952609661

Active Life, Llc is a Prosthetic/Orthotic Supplier based in Glendale, CA. Active Life, Llc practices in San Diego, CA. The NPI Number for Active Life, Llc is 1952609661 and holds a License No. (California).

The current practice location address for Active Life, Llc is 7910 Frost St Ste 320, San Diego, CA and can be reached out via phone at 619-488-6196 and via fax at 619-272-7615. You can also correspond with Active Life, Llc through the mailing address at 1577 E CHEVY CHASE DR, GLENDALE, CA - 91206-4147 (mailing address contact number: 818-495-4610).

Location: 7910 Frost St Ste 320, San Diego, CA, 91206-4147
institution
Provider Profile Details
NPI Number
1952609661
Provider Name
Active Life, Llc
Credential
Provider Entity Type
Organization
Address
7910 Frost St Ste 320, San Diego, CA, 91206-4147
Phone Number
619-488-6196
Fax Number
619-272-7615
Provider Enumeration Date
03/03/2011
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
XC0009601 05 CA
XC0009601 01 CA MEDI-CAL
institution
Provider Business Practice Location Address Details
Address
7910 Frost St Ste 320
City
State
Zip
92123
Phone Number
619-488-6196
Fax Number
619-272-7615
person
Provider Business Mailing Address Details
Address
7910 Frost St Ste 320
City
State
Zip
92123
Phone Number
619-488-6196
Fax Number
619-272-7615
person
Provider's Taxonomy Details 1
Type
Suppliers
Classification
Prosthetic/Orthotic Supplier
Speciality
-
Taxonomy
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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