MEDICARE: UPLIFT HEALTH AND WELLNESS

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	111N00000X	Chiropractor	DC32232	CA

General Provider Information

NPI Number	:	1851782262
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	UPLIFT HEALTH AND WELLNESS

Provider Business Mailing Address
First Line	:	27653 WESTON DR
Second Line	:
City	:	VALENCIA
State	:	CA
Zip	:	91354-1611
Country	:	US
Telephone Number	:	424-288-4285
Fax Number	:

Provider Business Practice Location Address
First Line	:	1022 PALM AVE
Second Line	:
City	:	WEST HOLLYWOOD
State	:	CA
Zip	:	90069-4005
Country	:	US
Telephone Number	:	424-288-4285
Fax Number	:

Authorized Official
Title or Position	:	MANAGER
Name	:	MR. MICHAEL HAMILTON
Credential	:
Telephone Number	:	424-288-4285

Provider Enumeration Date	:	02/08/2015
Last Update Date	:	02/08/2015

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Directions to “UPLIFT HEALTH AND WELLNESS ” Practice Location

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