# ACTIVE LIFE MEDICAL MANAGEMENT

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Active Life Medical
- **Organization subpart:** No

## Provider details

- **NPI number:** 1962415661
- **Authorized official:** JEFFREY SOUZA (PRESIDENT)
- **Authorized official phone:** (888) 525-0255

## Contact information

- **Practice address:** 1018 LIVE OAK BLVD., SUITE K, YUBA CITY, CA 95991
- **Practice address phone:** (888) 525-0255
- **Practice address fax:** (888) 525-0255
- **Mailing address:** PO BOX 586, YUBA CITY, CA 95992-0586
- **Mailing address phone:** (888) 525-0255
- **Mailing address fax:** (888) 525-0255

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332B00000X | Durable Medical Equipment & Medical Supplies | 0201003378 | VA | — |
| 332B00000X | Durable Medical Equipment & Medical Supplies | — | NULL | Yes |

## Other

- **Enumeration date:** 08/14/2006
- **Last updated:** 05/13/2015