ACTIVE LIFE INC (NPI# 1902852056) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1902852056 |
| Entity Type | Organization |
| Organization Name | ACTIVE LIFE INC |
| Practice Address |
18433 Roscoe Blvd Ste 108 Northridge CA 91325-4131 |
| Mailing Address |
1577 E Chevy Chase Dr Ste 210 Glendale CA 91206-4741 |
| Practice Telephone | 8188359441 |
| Practice Fax Number | 8185397962 |
| Mailing Telephone | 8184954610 |
| Mailing Fax Number | 8184842812 |
| Enumeration Date | 2006-05-26 |
| Last Update Date | 2018-03-01 |
| Authorized Official Name | SPENCER DOTY (PRESIDENT) |
| Authorized Official Telephone | 8185228781 |
| Authorized Official Credential | CPO |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 335E00000X | Prosthetic/Orthotic Supplier | CA | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | XC0009601 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740236819 | Active Life Inc | Prosthetic/Orthotic Supplier | 124 Alvarado Dr Se, Albuquerque, NM 87108-2940 | 2006-05-26 |
| 1215983366 | Active Life Inc | Prosthetic/Orthotic Supplier | 1577 E Chevy Chase Dr, Suite 210, Glendale, CA 91206-4107 | 2006-05-26 |
| Street Address |
18433 ROSCOE BLVD STE 108 |
| City | NORTHRIDGE |
| State | CA |
| Zip Code | 91325-4131 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396346961 | Patricia Yamilet Morales | Registered Nurse | 18300 Roscoe Blvd Dignity Health- Northridge Hospital M, Northridge, CA 91325 | 2020-11-02 |
| 1790342897 | Northridge Kidney Center, LLC | Clinic/Center | 17710 Roscoe Blvd, Northridge, CA 91325 | 2019-05-23 |
| 1063078376 | Ozlem Alper | Student in an Organized Health Care Education/Training Program | 18497 Dearborn St, Unit 112, Northridge, CA 91325 | 2019-05-13 |
| 1144883489 | Better Sober | Clinic/Center | 9339 Louse Ave, Northridge, CA 91325 | 2019-04-22 |
| 1902383920 | Ntr Resources, LLC | Pathology | 17433 Nordhoff, Northridge, CA 91325 | 2018-07-23 |
| 1043713969 | Poly-med Pharmacy Inc | Pharmacy | 17313 Roscoe Blvd, Northridge, CA 91325 | 2018-03-16 |
| 1982151940 | Maria Dakessian | Dentist | 18250 Roscoe Blvd Ste 345, Northridge, CA 91325 | 2016-09-07 |
| 1487019469 | Beshoy Gerges | Pharmacist | 8254 White Oak Ave Unit 4, Northridge, CA 91325 | 2015-12-17 |
| 1235520305 | Gema Bautista | Social Worker | 8550 Balboa Blvd Ste 216, Northridge, CA 91325 | 2015-02-11 |
| 1083018873 | Sosann Haider | Pharmacist | 18444 Plummer St., Northridge, CA 91325 | 2014-10-22 |
| Find all providers in zip 91325 | ||||
| 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 |
|---|---|---|---|---|
| 1023070885 | Vogue Prosthetic Orthotic Center, Inc | Prosthetic/Orthotic Supplier | 18519 Roscoe Blvd, Northridge, CA 91324-4632 | 2006-04-05 |
| 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 | NORTHRIDGE |
| Zip Code | 91325 |
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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.