Healthcare Provider Details

I. General information

NPI: 1225663826
Provider Name (Legal Business Name): UPPERLINE HEALTHCARE CALIFORNIA PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/04/2020
Last Update Date: 05/26/2023
Certification Date: 05/26/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1038 E CHAPMAN AVE
ORANGE CA
92866-2111
US

IV. Provider business mailing address

4101 CHARLOTTE AVE STE F185
NASHVILLE TN
37209-4066
US

V. Phone/Fax

Practice location:
  • Phone: 407-219-5402
  • Fax: 407-608-6830
Mailing address:
  • Phone: 407-219-5402
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QP1100X
TaxonomyPodiatric Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. MICHAEL J. KING
Title or Position: PRESIDENT
Credential: DPM
Phone: 407-219-5402