Organization
ACTIVECARERX PROVIDERS, LLC
Active
Organization
ACTIVECARERX PROVIDERS, LLC
Active
Other names
None Applicable
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JASON CARAMANIS (OWNER)
(818) 512-1991
Entity
Organization
Contact information
Practice address
4504 SAN BLAS AVE, WOODLAND HILLS, CA 91364-5429
(818) 512-1991
(818) 592-0494
Mailing address
4504 SAN BLAS AVE, WOODLAND HILLS, CA 91364-5429
(818) 512-1991
(818) 592-0494
Taxonomy
Speciality
Code
Description
License number
State
261QP0904X
Federal Public Health Clinic/Center
Primary
—
—
Other
Enumeration date
09/16/2014
Last updated
09/16/2014
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