Active Life, LLC

Primary specialty

Prosthetic/Orthotic SupplierTaxonomy code 335E00000X

Legal business name

ACTIVE LIFE, LLC

Practice address

403 W Adams Blvd Ste 201
Los Angeles, CA 90007-2664

Phone

(213) 814-4062

Fax

(213) 814-4079

NPI assigned

May 8, 2019

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Pallavi Chintapalli Nemani

Title

Compliance Officer

Phone

(512) 552-6311

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1557273600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1710720000000",
    "number": "1154986750",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1577 E CHEVY CHASE DR STE 210",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912064741",
            "telephone_number": "818-495-4610",
            "fax_number": "818-484-2812"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "403 W ADAMS BLVD STE 201",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900072664",
            "telephone_number": "213-814-4062",
            "fax_number": "213-814-4079"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ACTIVE LIFE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-05-08",
        "last_updated": "2024-03-18",
        "certification_date": "2024-03-18",
        "status": "A",
        "authorized_official_last_name": "NEMANI",
        "authorized_official_first_name": "PALLAVI",
        "authorized_official_middle_name": "CHINTAPALLI",
        "authorized_official_title_or_position": "COMPLIANCE OFFICER",
        "authorized_official_telephone_number": "512-552-6311"
    },
    "taxonomies": [
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "XC0009601",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Action Rehab Center Inc.
• Action Sober Living
• Active Care Home Health, Inc.
• Active Health Physical Therapy, Inc.
• Active Life Physical Therapy, Inc.
• Active Life, LLC
• Active Medical Equipment & Supplis
• Active Mobile Medical Group, Inc.
• Active Pain Relief Inc
• Acu Chiro Clinic

• Prosthetic/Orthotic Supplier in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Prosthetic/Orthotic Supplier in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.