DataLabs
datalabs.health made in the usa
DataLabs Facebook Wall   Like   Follow DataLabs on Twitter   Tweet  
Contact us Sign in |  Documentation | 
NPI Code Detail

MEDICARE: ACTIVE LIFE MEDICAL CENTER

MEDICARE: ACTIVE LIFE MEDICAL CENTER
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1111N00000XChiropractor14813CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
114813OTHERCALICENSE
2A69755OTHERCALICENSE

General Provider Information

NPI Number : 1639392798
Entity Type Code : Organization
Provider Name (Legal Business Name) : ACTIVE LIFE MEDICAL CENTER
Provider Business Mailing Address
First Line : 1391 WOODSIDE RD
Second Line : 200
City : REDWOOD CITY
State : CA
Zip : 94061-3578
Country : US
Telephone Number : 650-365-7775
Fax Number : 365-365-7896
Provider Business Practice Location Address
First Line : 1391 WOODSIDE RD
Second Line : 200
City : REDWOOD CITY
State : CA
Zip : 94061-3578
Country : US
Telephone Number : 650-365-7775
Fax Number : 365-365-7896
Authorized Official
Title or Position : MEDICAL DIRECTOR
Name : MR. HARRY KEVIN WONG
Credential : DC
Telephone Number : 650-365-7775
Provider Enumeration Date : 04/10/2007
Last Update Date : 10/09/2007

Similar Medicare Providers

1235205220 — DR. MANUEL BENEDICTO PANIAGUA D.C.
Practice Location Address:
1391 WOODSIDE RD , STE. 200
REDWOOD CITY, CA
94061-3578
Practice Phone: 650-365-7775
Practice Fax: 650-365-7896
1518263490 — DR. JERALD R HANNAH D.C.
Practice Location Address:
1391 WOODSIDE RD , SUITE 200
REDWOOD CITY, CA
94061-3578
Practice Phone: 650-365-7775
Practice Fax:
1053742965 — JOHANNA POON OD A PROFESSIONAL CORPORATION
Practice Location Address:
1391 WOODSIDE RD , SUITE 218
REDWOOD CITY, CA
94061-3578
Practice Phone: 408-209-6808
Practice Fax:
1447389564 — AMAZING TOUCH REHABILITATION & WELLNESS CENTER PC
Practice Location Address:
319 BARROW ST , SUITE 1A
JERSEY CITY, NJ
07302-3578
Practice Phone: 201-433-2096
Practice Fax:
1437393162 — APPLEGATE
Practice Location Address:
1605 BENTON RD , SUITE D
BOSSIER CITY, LA
71111-3578
Practice Phone: 318-742-0500
Practice Fax: 318-742-0588
1205167244 — DOLAINNA PHYSICAL THERAPY CENTER INC
Practice Location Address:
3760 CAHUENGA BLVD , UNIT 204
STUDIO CITY, CA
91604-3578
Practice Phone: 181-876-3363
Practice Fax:

Directions to “ACTIVE LIFE MEDICAL CENTER ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.