Provider Demographics
NPI:1568787398
Name:UPLAND ORTHOPEDIC ASSOCIATES, INC.
Entity Type:Organization
Organization Name:UPLAND ORTHOPEDIC ASSOCIATES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JAYPRAKASH
Authorized Official - Middle Name:N
Authorized Official - Last Name:SHAH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:909-986-0494
Mailing Address - Street 1:1520 N MOUNTAIN AVE
Mailing Address - Street 2:SUITE 205 BUILDING E
Mailing Address - City:ONTARIO
Mailing Address - State:CA
Mailing Address - Zip Code:91762-1128
Mailing Address - Country:US
Mailing Address - Phone:909-986-0494
Mailing Address - Fax:909-986-0497
Practice Address - Street 1:1520 N MOUNTAIN AVE
Practice Address - Street 2:SUITE 205 BUILDING E
Practice Address - City:ONTARIO
Practice Address - State:CA
Practice Address - Zip Code:91762-1128
Practice Address - Country:US
Practice Address - Phone:909-986-0494
Practice Address - Fax:909-986-0497
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-05
Last Update Date:2010-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty