ACTIVE LIFE, INC. (NPI# 1154986750) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1154986750 |
| Entity Type | Organization |
| Organization Name | ACTIVE LIFE, INC. |
| Practice Address |
3407 W 6th St Ste 815 Los Angeles CA 90020-2555 |
| Mailing Address |
1577 E Chevy Chase Dr Ste 210 Glendale CA 91206-4741 |
| Practice Telephone | 2138144062 |
| Practice Fax Number | 2138144079 |
| Mailing Telephone | 8184954610 |
| Mailing Fax Number | 8184842812 |
| Enumeration Date | 2019-05-08 |
| Last Update Date | 2019-09-10 |
| Authorized Official Name | MR. SPENCER ARDEN 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 | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | XC0009601 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 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 |
| 1568961977 | Active Life, Inc. | Prosthetic/Orthotic Supplier | 855 N Lark Ellen Ave Ste A, West Covina, CA 91791-1099 | 2018-02-12 |
| 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 |
3407 W 6TH ST STE 815 |
| City | LOS ANGELES |
| State | CA |
| Zip Code | 90020-2555 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164948048 | Edwina Antoinette Hunter | Community Health Worker | 550 S. Vermont Ave, 6th Floor, Los Angeles, CA 90020 | 2017-08-22 |
| 1639520661 | Jacqueline Carrasco | Counselor | 550 South Vermont Ave, 10th Floor, Los Angeles, CA 90020 | 2016-06-30 |
| 1649630914 | Hee Seung Lee | Marriage & Family Therapist | 3727 W. 6th Street, Suite 507, Los Angeles, CA 90020 | 2016-03-01 |
| 1134596273 | Jocelyn Marie Lee | Optometrist | 3750 W 6th St Ste 113, Los Angeles, CA 90020 | 2015-08-24 |
| 1316327075 | Lourdes Encarnacion Araujo | Social Worker | 550 S Vermont Ave 3rd Floor, Los Angeles, CA 90020 | 2015-06-08 |
| 1477933463 | Department of Mental Health | Clinic/Center | 550 South Vermont, Los Angeles, CA 90020 | 2015-06-04 |
| 1538566047 | Calvin A. Kim | Internal Medicine | 4220 W 3rd St Ste 201, Los Angeles, CA 90020 | 2014-11-26 |
| 1093115792 | John Abaya | Counselor | 550 S Vermont Ave 10th Floor, Los Angeles, CA 90020 | 2014-08-29 |
| 1528494481 | Sung Eun Lee | Acupuncturist | 340 S New Hampshire Ave #211, Los Angeles, CA 90020 | 2013-09-23 |
| 1861836587 | Robert Lee Smalls Jr. | Marriage & Family Therapist | 550 South Vermont Avenue, Juvenile Justice Transition Aftercare Services Division, Los Angeles, CA 90020 | 2013-04-24 |
| Find all providers in zip 90020 | ||||
| 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 |
|---|---|---|---|---|
| 1952765711 | Active Life, Inc. | Prosthetic/Orthotic Supplier | 1700 E Cesar E Chavez Ave Ste 3750, Los Angeles, CA 90033 | 2016-04-07 |
| 1033511126 | Michelle Dabadie | Prosthetic/Orthotic Supplier | 9022 Burton Way, Los Angeles, CA 90211 | 2014-09-19 |
| 1467580423 | Miss Stevens for Lingerie | Prosthetic/Orthotic Supplier | 2235 S Sepulveda Blvd, Los Angeles, CA 90064-1811 | 2007-03-01 |
| 1568509669 | Dynamics Orthotics & Prosthetics, Inc. | Prosthetic/Orthotic Supplier | 1830 W Olympic Blvd, Suite #123, Los Angeles, CA 90006-3734 | 2007-01-30 |
| 1316963770 | Nordstrom Inc & Subsidiaries | Prosthetic/Orthotic Supplier | 189 The Grove Dr Ste P80, Los Angeles, CA 90036-6229 | 2006-07-15 |
| 1598790081 | Nordstrom Inc & Subsidiaries | Prosthetic/Orthotic Supplier | 10830 W Pico Blvd, Los Angeles, CA 90064-2106 | 2006-07-12 |
| 1598799090 | Action Orthopedic Company, LLC | Prosthetic/Orthotic Supplier | 1515 Wilshire Blvd Unit 3, Los Angeles, CA 90017-2216 | 2006-07-10 |
| 1639125081 | Ortho Engineering Inc | Prosthetic/Orthotic Supplier | 1436 S La Cienega Blvd Ste 102, Los Angeles, CA 90035-3764 | 2006-05-26 |
| 1508855776 | Global Prosthetics & Orthotics | Prosthetic/Orthotic Supplier | 2021 W Florence Ave, Los Angeles, CA 90047 | 2005-10-19 |
| 1558896407 | Team Makena LLC | Prosthetic/Orthotic Supplier | 6801 Park Terrace Drive, 110, Los Angeles, CA 90045-1544 | 2017-04-28 |
| Find all providers in LOS ANGELES | ||||
| City | LOS ANGELES |
| Zip Code | 90020 |
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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.