MEDICARE: UPPERLINE HEALTHCARE CALIFORNIA, PC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	213ES0103X	Foot & Ankle Surgery Podiatrist

General Provider Information

NPI Number	:	1376241018
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	UPPERLINE HEALTHCARE CALIFORNIA, PC

Provider Business Mailing Address
First Line	:	4101 CHARLOTTE AVE STE F185
Second Line	:
City	:	NASHVILLE
State	:	TN
Zip	:	37209-4066
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	604 S HARBOR BLVD
Second Line	:
City	:	SANTA ANA
State	:	CA
Zip	:	92704-1340
Country	:	US
Telephone Number	:	657-467-3310
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MICHAEL J KING
Credential	:
Telephone Number	:	407-219-5402

Provider Enumeration Date	:	02/22/2023
Last Update Date	:	05/29/2026

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