Provider Demographics
NPI:1760094908
Name:UPPERLINE HEALTHCARE CALIFORNIA PC
Entity Type:Organization
Organization Name:UPPERLINE HEALTHCARE CALIFORNIA PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:J
Authorized Official - Last Name:KING
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:615-627-2204
Mailing Address - Street 1:102 WOODMONT BLVD STE 450
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37205-5202
Mailing Address - Country:US
Mailing Address - Phone:615-627-2204
Mailing Address - Fax:615-970-7118
Practice Address - Street 1:241 W OLIVE AVE
Practice Address - Street 2:
Practice Address - City:BURBANK
Practice Address - State:CA
Practice Address - Zip Code:91502-1825
Practice Address - Country:US
Practice Address - Phone:818-848-5583
Practice Address - Fax:818-848-1872
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-19
Last Update Date:2021-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Multi-Specialty