ACTIVE LIFE, INC. (NPI# 1942865605) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1942865605 |
| Entity Type | Organization |
| Organization Name | ACTIVE LIFE, INC. |
| Practice Address |
16008 Kamana Rd Apple Valley CA 92307-1376 |
| Mailing Address |
1577 E Chevy Chase Dr Ste 210 Glendale CA 91206-4741 |
| Practice Telephone | 7604106182 |
| Practice Fax Number | 7604106187 |
| Mailing Telephone | 8184954610 |
| Enumeration Date | 2019-05-07 |
| Last Update Date | 2019-05-07 |
| Authorized Official Name | SPENCER ARDEN DOTY (PRESIDENT) |
| Authorized Official Telephone | 8184954610 |
| 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 |
|---|---|---|---|---|
| 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 |
| 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 |
| 1619475894 | Active Life, Inc. | Prosthetic/Orthotic Supplier | 20911 Earl St Ste 290, Torrance, CA 90503-4354 | 2018-01-23 |
| Street Address |
16008 KAMANA RD |
| City | APPLE VALLEY |
| State | CA |
| Zip Code | 92307-1376 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356404305 | Michael D Jasso | Physician Assistant | 16008 Kamana Rd, Ste 100, Apple Valley, CA 92307-1376 | 2006-12-19 |
| 1043531676 | Mack Green | Family Medicine | 16008 Kamana Rd, Suite 100, Apple Valley, CA 92307-1376 | 2010-06-17 |
| 1457670226 | Southern California Bone and Joint Clinic Inc | Orthopaedic Surgery | 16008 Kamana Rd, Suite 100, Apple Valley, CA 92307-1376 | 2010-05-19 |
| 1922201318 | Tzu-shang Thomas Liu | Orthopaedic Surgery | 16008 Kamana Rd, Suite 100, Apple Valley, CA 92307-1308 | 2007-06-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679106025 | Rajender S. Thakran, M.d., Inc | Specialist | 16030 Kamana Rd, Apple Valley, CA 92307 | 2020-02-13 |
| 1477119980 | Harpreet Singh | Nurse Practitioner | 18300 Ca-18, Apple Valley, Ca 92307, Apple Valley, CA 92307 | 2019-05-10 |
| 1184120784 | Frantz Jean-louis | Nurse Practitioner | 16134 Muni Rd, Apple Valley, CA 92307 | 2018-04-03 |
| 1053862078 | Ashley M Morello | Registered Nurse | Universal Pain Management, 16179 Siskiyou, Apple Valley, CA 92307 | 2016-10-14 |
| 1891191680 | Ann Simonds | Marriage & Family Therapist | 20601 Us Highway 18 Ste 123, Apple Valley, CA 92307 | 2014-11-06 |
| 1396147419 | Aaa Family Medical Group | Family Medicine | 15995 Tuscola Rd Ste 202, Apple Valley, CA 92307 | 2014-09-19 |
| 1659780534 | Relena Tran | Pharmacist | 20251 Highway 18, Apple Valley, CA 92307 | 2014-08-05 |
| 1639508526 | Meagan Katherine Blades | Physician Assistant | 18300 Outer Hwy 18, Apple Valley, CA 92307 | 2013-11-01 |
| 1720341555 | Jonathan Robert Cox | Dermatology | 18523 Corwin Rd Ste G, Apple Valley, CA 92307 | 2012-06-18 |
| 1821364365 | Leary Sport and Spine Chiropractic Inc. | Chiropractor | 18564 Us Highway 18 Suite, 303, Apple Valley, CA 92307 | 2012-03-29 |
| Find all providers in zip 92307 | ||||
| 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 |
|---|---|---|---|---|
| 1649514845 | Dynamics Orthotics & Prosthetics, Inc. | Prosthetic/Orthotic Supplier | 16077 Kamana Rd, Suite 100, Apple Valley, CA 92307-1331 | 2012-11-12 |
| 1609040393 | Lstep Footsolutions | Prosthetic/Orthotic Supplier | 15594 Pilot Knob Rd, Suite 400, Apple Valley, MN 55124-7295 | 2008-04-15 |
| 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 | APPLE VALLEY |
| Zip Code | 92307 |
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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.