| Active Life Healthcare | |
|
380 Camino De Estrella San Clemente CA 92672-4859 | |
| (949) 487-1231 | |
| Not Available |
| Full Name | Active Life Healthcare |
|---|---|
| Speciality | Clinic/center |
| Location | 380 Camino De Estrella, San Clemente, California |
| Authorized Official Name and Position | Michael Anthony Coppola (PRESIDENT) |
| Authorized Official Contact | 9494871231 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Active Life Healthcare 380 Camino De Estrella San Clemente CA 92672-4859 Ph: (949) 487-1231 | Active Life Healthcare 380 Camino De Estrella San Clemente CA 92672-4859 Ph: (949) 487-1231 |
| NPI Number | 1023254653 |
|---|---|
| Provider Enumeration Date | 01/03/2009 |
| Last Update Date | 03/01/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1023254653 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | DC 30393 (California) | Primary |
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