| NPI | 1023254653 |
|---|---|
| Doing Business As | ACTIVE LIFE HEALTHCARE |
| Entity Type | Organization |
| Authorized Contact | MICHAEL ANTHONY COPPOLA President 949-487-1231 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center (Licence: CA DC 30393) |
| Enumeration Date | 2009-01-03 |
| Last Update Date | 2012-03-01 |