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Contact Information

ACTIVE LIFE, LLC
403 W ADAMS BLVD STE 201
LOS ANGELES, CA90007-2664
 Phone: 213-814-4062
 Fax: 213-814-4079
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Prosthetic/Orthotic Supplier

335E00000X 51 Medical Supply Company with Orthotist
Indicates primary specialty

NPI Profile & details for ACTIVE LIFE, LLC

NPI # 1154986750
LBN Legal business name ACTIVE LIFE, LLC
Authorized official PALLAVI NEMANI - (COMPLIANCE OFFICER)
Entity Organization
Organization subpart 1 No
Enumeration date 05/08/2019
Last updated 03/18/2024 - About 2 years ago
Identifiers
CA Medicaid XC0009601
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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