ACTIVE LIFE, INC. (NPI# 1568961977) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1568961977 |
| Entity Type | Organization |
| Organization Name | ACTIVE LIFE, INC. |
| Practice Address |
855 N Lark Ellen Ave Ste A West Covina CA 91791-1099 |
| Mailing Address |
1577 E Chevy Chase Dr Ste 210 Glendale CA 91206-4741 |
| Practice Telephone | 6267276455 |
| Practice Fax Number | 6263603220 |
| Mailing Telephone | 8184954610 |
| Mailing Fax Number | 8184842812 |
| Enumeration Date | 2018-02-12 |
| Last Update Date | 2018-02-12 |
| Authorized Official Name | SPENCER ARDEN DOTY (PRESIDENT) |
| Authorized Official Telephone | 8184954610 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 335E00000X | Prosthetic/Orthotic Supplier | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | XC0009601 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154986750 | Active Life, Inc. | Prosthetic/Orthotic Supplier | 3407 W 6th St Ste 815, Los Angeles, CA 90020-2555 | 2019-05-08 |
| 1609342914 | Active Life, Inc. | Prosthetic/Orthotic Supplier | 1980 Orange Tree Ln Ste 230, Redlands, CA 92374-4559 | 2018-10-15 |
| 1063902708 | Active Life, Inc. | Prosthetic/Orthotic Supplier | 1710 Plum Ln Ste C, Redlands, CA 92374-0100 | 2018-05-17 |
| 1669988176 | Active Life, Inc. | Prosthetic/Orthotic Supplier | 29645 Rancho California Rd Ste 213, Temecula, CA 92591-5285 | 2017-12-19 |
| 1497264733 | Active Life, Inc. | Prosthetic/Orthotic Supplier | 23141 Moulton Pkwy Ste 109, Laguna Hills, CA 92653-1241 | 2017-09-28 |
| 1952765711 | Active Life, Inc. | Prosthetic/Orthotic Supplier | 1700 E Cesar E Chavez Ave Ste 3750, Los Angeles, CA 90033 | 2016-04-07 |
| 1952609661 | Active Life, Inc. | Prosthetic/Orthotic Supplier | 7910 Frost St Ste 320, San Diego, CA 92123 | 2011-03-03 |
| 1073162244 | Active Life, Inc. | Prosthetic/Orthotic Supplier | 3300 E South St Ste 305, Lakewood, CA 90805-4595 | 2019-09-10 |
| 1942865605 | Active Life, Inc. | Prosthetic/Orthotic Supplier | 16008 Kamana Rd, Apple Valley, CA 92307-1376 | 2019-05-07 |
| 1619475894 | Active Life, Inc. | Prosthetic/Orthotic Supplier | 20911 Earl St Ste 290, Torrance, CA 90503-4354 | 2018-01-23 |
| Street Address |
855 N LARK ELLEN AVE STE A |
| City | WEST COVINA |
| State | CA |
| Zip Code | 91791-1099 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366938896 | Oriental Holistic Acupuncture Healthe Center Inc | Acupuncturist | 1414 S. Azusa Ave., Ste B-5, West Covina, CA 91791 | 2018-07-09 |
| 1780110312 | Yenmien Chen | Pharmacist | 5944 N Figueroa Ave, Los Angeles, CA 91791 | 2017-05-02 |
| 1568861227 | Gashparova Dental Practice Inc. | Dentist | 628 N. Azusa Ave., West Covina, CA 91791 | 2014-08-19 |
| 1740607837 | Melinda Rodriguez-mendoza | Nurse Practitioner | 1444 E Mcwood St, West Covina, CA 91791 | 2014-03-26 |
| 1710245782 | Mark Chevy S Ledesma | Dentist | 319 N Azusa Ave., W Covina, CA 91791 | 2012-04-27 |
| 1508184920 | Elba Cecilia Olivares | Chiropractor | 743 S. Hillward Ave, West Covina, CA 91791 | 2010-05-10 |
| 1861668832 | Susette C Thompson | Case Manager/Care Coordinator | 1829 Eworkman Ave #1, West Covina, CA 91791 | 2008-04-30 |
| 1376729483 | Accentcare Home Health of California, Inc. | Home Health | 2934 E Garvey Ave S Ste 210, West Covina, CA 91791 | 2008-01-18 |
| 1629195870 | Jung Jung Liu | Dentist | 628 North Azusa Ave, West Covina, CA 91791 | 2007-03-23 |
| 1548302748 | Mark Chevy S Ledesma Dds Inc | Dentist | 319 N Azusa Ave, W Covina, CA 91791 | 2007-02-13 |
| Find all providers in zip 91791 | ||||
| Taxonomy Code | 335E00000X |
| Grouping | Suppliers |
| Classification | Prosthetic/Orthotic Supplier |
| 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. |
| Notes: Source: American Board for Certification in Orthotics, Prosthetics, and Pedorthics, Inc. [7/1/2010: modified, 7/1/2013: modified] Additional Resources: American Board for Certification in Orthotics, Prosthetics and Pedorthics, Inc., www.abcop.org and Board of Certification/Accreditation, International, www.bocusa.org. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306202353 | Ducens Med-tech, Inc | Prosthetic/Orthotic Supplier | 933 S Sunset Ave, Suite 101, West Covina, CA 91790-3410 | 2016-01-06 |
| 1730450784 | Ortho Engineering Inc | Prosthetic/Orthotic Supplier | 741 S Orange Ave, West Covina, CA 91790-2662 | 2012-01-23 |
| 1073651139 | Premier Orthotic and Prosthetic Services Inc | Prosthetic/Orthotic Supplier | 855 N Lark Ellen Ave, Ste I, West Covina, CA 91791-1099 | 2007-02-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821696592 | Cranial Technologies, Inc. | Prosthetic/Orthotic Supplier | 3031 W March Ln Ste 216w, Stockton, CA 95219-6500 | 2020-10-14 |
| 1871191742 | Alcam Medical Inc. | Prosthetic/Orthotic Supplier | 1244 N Mariposa St Ste 10, Fresno, CA 93703-3929 | 2020-10-13 |
| 1740887462 | A-z Consulting O & P Services | Prosthetic/Orthotic Supplier | 1133 Smith Ln Ste 5, Roseville, CA 95661-4131 | 2020-10-06 |
| 1255938452 | Sheek Hair Boutique | Prosthetic/Orthotic Supplier | 1432 N Cedar Ave Apt 107, Fresno, CA 93703-5303 | 2020-10-01 |
| 1922615368 | Inland Artificial Limb & Brace | Prosthetic/Orthotic Supplier | 1101 Bryan Ave Ste C, Tustin, CA 92780-4401 | 2020-09-29 |
| 1043823461 | Crystal Johnson | Prosthetic/Orthotic Supplier | 812 S Flower St Apt 4, Inglewood, CA 90301-7913 | 2020-08-25 |
| 1225640220 | Christopher Holloway | Prosthetic/Orthotic Supplier | 4517 Market St Ste 4, Ventura, CA 93003-7841 | 2020-08-20 |
| 1407468416 | Cranial Technologies, Inc. | Prosthetic/Orthotic Supplier | 488 E Valley Pkwy Ste 207, Escondido, CA 92025-3368 | 2020-08-20 |
| 1801406269 | Restore Medical Inc | Prosthetic/Orthotic Supplier | 1505 Soquel Dr Ste 4, Santa Cruz, CA 95065-1716 | 2020-07-31 |
| 1801404199 | Covering With Care | Prosthetic/Orthotic Supplier | 21350 Avalon Blvd Unit 5039, Carson, CA 90749-7032 | 2020-07-22 |
| Find all providers with the same taxonomy | ||||
| City | WEST COVINA |
| Zip Code | 91791 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.