NPI 1174293997

Active Life, LLC

Organisation Prosthetic/Orthotic Supplier Murrieta, CA

Practice location

Address: 25405 Hancock Ave STE 213, Murrieta, CA 92562-5978
Phone: (951) 698-0505
Fax: (951) 335-0707
Mailing address: 1577 E Chevy Chase Dr STE 210, Glendale, CA 91206-4741

Authorised official

Name: Pallavi Chintapalli Nemani
Title: Compliance Officer
Phone: (512) 552-6311

Registered specialties

Prosthetic/Orthotic Supplier Primary

Suppliers Taxonomy 335E00000X

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Registry record

NPI: 1174293997
Entity type: Organization
NPI issued: 14 Sep 2021
Record last updated: 23 Jan 2023

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.