Active Potential Incorporated

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

License

45651 Issued in CA

Legal business name

ACTIVE POTENTIAL INCORPORATED

Practice address

7898 Ostrow St
Suite G
San Diego, CA 92111-3640

Phone

(858) 292-4128

Fax

(858) 292-4833

NPI assigned

Aug 21, 2006

Last updated

Mar 13, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ms. Anna K Pollard

Title

President/Manager

Phone

(858) 292-4128

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1156118400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1205366400000",
    "number": "1407962624",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7898 OSTROW ST",
            "address_2": "SUITE G",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921113640",
            "telephone_number": "858-292-4128",
            "fax_number": "858-292-4833"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7898 OSTROW ST",
            "address_2": "SUITE G",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921113640",
            "telephone_number": "858-292-4128",
            "fax_number": "858-292-4833"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ACTIVE POTENTIAL INCORPORATED",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-21",
        "last_updated": "2008-03-13",
        "status": "A",
        "authorized_official_last_name": "POLLARD",
        "authorized_official_first_name": "ANNA",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "PRESIDENT/MANAGER",
        "authorized_official_telephone_number": "858-292-4128",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "CA",
            "license": "45651",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "DME03416F",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Durable Medical Equipment & Medical Supplies in San Diego, CA
• Providers in San Diego, CA by specialty
• Durable Medical Equipment & Medical Supplies in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2008; 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.