Healthcare Provider Details

I. General information

NPI: 1033064852
Provider Name (Legal Business Name): NUPUR RAJKARAN PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/27/2026
Last Update Date: 02/27/2026
Certification Date: 02/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10180 W HAPPY VALLEY PKWY
PEORIA AZ
85383-1389
US

IV. Provider business mailing address

10180 W HAPPY VALLEY PKWY
PEORIA AZ
85383-1389
US

V. Phone/Fax

Practice location:
  • Phone: 623-776-7500
  • Fax:
Mailing address:
  • Phone: 623-227-4654
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number11598
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: