Active Life Medical Management

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

ACTIVE LIFE MEDICAL MANAGEMENT

Doing business as

Active Life Medical

Practice address

1018 Live Oak Blvd., Suite K
Yuba City, CA 95991

Phone

(888) 525-0255

Fax

(888) 525-0255

NPI assigned

Aug 14, 2006

Last updated

May 13, 2015By 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

Jeffrey Souza

Title

President

Phone

(888) 525-0255

Specialties & licenses 2

Addresses

Other identifiers 3

Other names 1

• Active Life Medical Doing business as

Locations

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

{
    "created_epoch": "1155513600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1431475200000",
    "number": "1962415661",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 586",
            "city": "YUBA CITY",
            "state": "CA",
            "postal_code": "959920586",
            "telephone_number": "888-525-0255",
            "fax_number": "888-525-0255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1018 LIVE OAK BLVD., SUITE K",
            "city": "YUBA CITY",
            "state": "CA",
            "postal_code": "95991",
            "telephone_number": "888-525-0255",
            "fax_number": "888-525-0255"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ACTIVE LIFE MEDICAL MANAGEMENT",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-14",
        "last_updated": "2015-05-13",
        "status": "A",
        "authorized_official_last_name": "SOUZA",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "888-525-0255"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "VA",
            "license": "0201003378",
            "primary": false
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "262513",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UMWA",
            "identifier": "1526243",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1962415661",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Active Life Medical",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Durable Medical Equipment & Medical Supplies in Yuba City, CA
• Providers in Yuba City, 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 May 13, 2015; 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.