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AGELESS MEN'S HEALTH
NPI 1083052864
Specialist in Seal Beach, CA

Active since June 13, 2013CLIA 05D2032139 · Waiver
12501 SEAL BEACH BLVD STE 220, SEAL BEACH, CA 90740(562) 685-9367 Get Directions Write a Review

NPPES record last updated: November 11, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Nov 11, 2024, Nov 13, 2023, Sep 5, 2023 (3 updates tracked since 2023).

About Ageless Men's Health NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

AGELESS MEN'S HEALTH (NPI 1083052864) is a healthcare organization registered as a specialist in Seal Beach, California and active in the NPI registry since June 2013. The organization holds a CLIA Waiver certificate valid through November 3, 2027 and lists Amanda Wilkinson, Business Operations Director, as its authorized official.

NPPES Registry Identity

NPI1083052864
Entity TypeOrganization
Primary Taxonomy174400000X
Legal Business NameAGELESS MEN'S HEALTH CA PPC
Location Address12501 SEAL BEACH BLVD STE 220Seal Beach, CA 90740-2755
Mailing Address12501 Seal Beach Blvd Ste 220Seal Beach, CA 90740-2755 · (949) 854-8378 · Fax (949) 854-8379
Phone(562) 685-9367
Organization SubpartNo
Authorized OfficialAmanda WilkinsonBusiness Operations Director · (702) 818-0446
Enumeration DateJune 13, 2013
Last NPPES UpdateNovember 11, 20243 updates tracked since enumeration
NPPES CertifiedNovember 11, 2024
✔ NPI 1083052864 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySpecialistOther Service Providers
Taxonomy Code174400000X
Definition
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
12501 SEAL BEACH BLVD STE 220, Seal Beach, CA 90740
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Other Names 1

Doing Business AsAgeless Men's Health

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 05D2032139

Ageless Men's Health - Irvine · Irvine, CA
Active · expires Nov 3, 2027
CLIA Number05D2032139
Laboratory TypePhysician Office
Certificate Effective DateNovember 4, 2025
Certificate Expiration DateNovember 3, 2027
Laboratory DirectorKenneth Grubbs
Laboratory Phone(949) 854-8378
Laboratory LocationAgeless Men's Health - Irvine6825 Quail Hill Parkway, Irvine, CA 92603
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

JASMINE ELIZABETH SAMSON FNP-C
Nurse Practitioner (Family)
12501 SEAL BEACH BLVD STE 220
SEAL BEACH, CA 90740
Orange County (562) 430-1666
JAMES JOSEPH CONSTABILEO PHYSICIAN ASSISTANT
Physician Assistant (Medical)
12501 SEAL BEACH BLVD STE 220
SEAL BEACH, CA 90740
Orange County (562) 430-1666

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Ageless Men's Health Ca Ppc's NPI number?

The NPI number for Ageless Men's Health Ca Ppc is 1083052864. It was assigned to this organization in the NPPES registry on June 13, 2013. The provider is doing business as Ageless Men's Health.

Where is Ageless Men's Health Ca Ppc located?

Ageless Men's Health Ca Ppc is located at 12501 Seal Beach Blvd Ste 220, Seal Beach, CA 90740. The listed phone number is (562) 685-9367.

What is Ageless Men's Health Ca Ppc's specialty?

The primary specialty registered for this NPI is Specialist with taxonomy code 174400000X.

Does Ageless Men's Health Ca Ppc hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 05D2032139) is associated with this NPI, valid through November 3, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Ageless Men's Health Ca Ppc was last updated on November 11, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 20 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.