Active Life, LLC

Primary specialty

Prosthetic/Orthotic SupplierTaxonomy code 335E00000X

Legal business name

ACTIVE LIFE, LLC

Practice address

1700 E Cesar E Chavez Ave Ste 3750
Los Angeles, CA 90033

Phone

(323) 352-8319

Fax

(323) 425-8392

NPI assigned

Apr 7, 2016

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": "1459987200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1674518400000",
    "number": "1952765711",
    "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": "1700 E CESAR E CHAVEZ AVE STE 3750",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "90033",
            "telephone_number": "323-352-8319",
            "fax_number": "323-425-8392"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ACTIVE LIFE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-04-07",
        "last_updated": "2023-01-24",
        "certification_date": "2023-01-24",
        "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": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDI CAL",
            "identifier": "XC0009601",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Active Medical Equipment & Supplis
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• Acu Chiro Clinic
• Acu Therapy Pain Clinic, Inc

• 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 Jan 24, 2023; 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.