Organization
ACTIVE POTENTIAL INCORPORATED
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. ANNA K POLLARD (PRESIDENT/MANAGER)
(858) 292-4128
Entity
Organization
Contact information
Practice address
7898 OSTROW ST, SUITE G, SAN DIEGO, CA 92111-3640
(858) 292-4128
(858) 292-4833
Mailing address
7898 OSTROW ST, SUITE G, SAN DIEGO, CA 92111-3640
(858) 292-4128
(858) 292-4833
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
45651
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
DME03416F
—
CA
Enumeration date
08/21/2006
Last updated
03/13/2008
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