Organization
ACTIVEHEALTHRX, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
IAN LICHTWARDT (DIRECTOR)
(310) 741-7799
Entity
Organization
Contact information
Practice address
8500 WILSHIRE BLVD, PH, BEVERLY HILLS, CA 90211-3121
(310) 652-0085
(866) 390-0007
Mailing address
8500 WILSHIRE BLVD, PH, BEVERLY HILLS, CA 90211-3121
(310) 652-0085
(866) 390-0007
Taxonomy
Speciality
Code
Description
License number
State
246RP1900X
Phlebotomy Technician
CPT54625
CA
261QH0100X
Health Service Clinic/Center
Primary
—
—
Other
Enumeration date
04/09/2013
Last updated
04/23/2013
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