Active Life, Llc is a Prosthetic & Orthotic Supplier (Prosthetic & Orthotic Supplier) in Lakewood, California. It is situated at 3300 E South St Ste 305, Lakewood and its contact number is 562-304-9866. The authorized person of Active Life, Llc is Spencer Arden Doty
who is President of the store and his/her contact number is 858-616-7724. Active Life, Llc is 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.
Complete Center Profile:
Active Life, Llc Center speciality, address, contact phone number and fax are as below.
Patients can directly walkin to the Prosthetic/Orthotic center or can call on the below given phone number for appointment.
3300 E South St Ste 305, Lakewood, California, 90805-4595
Phone:
562-304-9866
Fax:
562-304-9845
Authorized/Official Person Profile:
Officially authorized person to contact for any management issues or complaints of this store are as below. Person's position and contact details are also mentioned below.
Name:
Spencer Arden Doty
Position:
President
Contact Number:
858-616-7724
Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS).
NPI details for Active Life, Llc center are as mentioned below.
NPI Number:
1073162244
NPI Enumeration Date:
10 Sep, 2019
NPI Last Update On:
14 Jan, 2021
Medical Licenses:
Organizations can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Active Life, Llc are as mentioned below.
Specialization
License Number
State
Status
Primary
Other Medical Identifiers:
Other legacy medical identifiers of the supplier such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned as below.
Identifier
Type
State
Issuer
XC0009601
Medicaid
California
Business Mailing Address:
Business mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned address.
Address:
Active Life, Llc 1577 E Chevy Chase Dr Ste 210, Glendale, California
Zip:
91206-4741
Phone Number:
818-495-4610
Fax Number:
818-484-2812
Patients can reach Active Life, Llc at 3300 E South St Ste 305, Lakewood, California or can call to book an appointment on 562-304-9866. Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on 11 March, 2024.