Organization · NPI-2

Activecarerx Providers, LLC

Clinic/Center, Public Health, Federal · Woodland Hills, CA

NPI number1871995357
StatusActive
Last updated in NPPESSep 16, 2014

Details

NPI
1871995357
Entity type
Organization (NPI-2)
Legal business name
Activecarerx Providers, LLC
Organization subpart
No
Enumeration date
Sep 16, 2014
Last updated
Sep 16, 2014

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
261QP0904X Clinic/Center, Public Health, Federal––Yes

Other names

  • None Applicable (Former Legal Business Name)

Practice location

4504 San Blas Ave
Woodland Hills, CA 91364-5429

Phone 818-512-1991 · Fax 818-592-0494

Mailing address

4504 San Blas Ave
Woodland Hills, CA 91364-5429

Phone 818-512-1991 · Fax 818-592-0494

Authorized official

Jason Caramanis
Owner
8185121991

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