Provider Demographics
NPI:1487622361
Name:FORSLING, MICHAEL (DPM)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:
Last Name:FORSLING
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3144 SANTA ANITA AVE
Mailing Address - Street 2:SUITE 202
Mailing Address - City:EL MONTE
Mailing Address - State:CA
Mailing Address - Zip Code:91733-1316
Mailing Address - Country:US
Mailing Address - Phone:626-582-7908
Mailing Address - Fax:626-401-0171
Practice Address - Street 1:3144 SANTA ANITA AVE
Practice Address - Street 2:SUITE 202
Practice Address - City:EL MONTE
Practice Address - State:CA
Practice Address - Zip Code:91733-1316
Practice Address - Country:US
Practice Address - Phone:626-582-7908
Practice Address - Fax:626-401-0171
Is Sole Proprietor?:No
Enumeration Date:2006-03-08
Last Update Date:2013-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAE3435213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAT11692Medicare UPIN