| NPI | 1417767518 |
|---|---|
| Doing Business As | ACTIVE HEALTH CLINIC |
| Entity Type | Organization |
| Authorized Contact | KASSRA MICHAEL KHAZALPOUR President 415-279-0947 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice |
| Additional Taxonomies | 171400000X Health & Wellness Coach |
| 174H00000X Health Educator | |
| 207QS0010X Family Medicine, Sports Medicine | |
| 2083P0901X Preventive Medicine, Public Health & General Preventive Medicine | |
| 251E00000X Home Health | |
| 251F00000X Home Infusion | |
| 261Q00000X Clinic/Center | |
| 261QH0100X Clinic/Center, Health Services | |
| Enumeration Date | 2025-01-10 |
| Last Update Date | 2025-01-27 |