Healthcare Provider Details

I. General information

NPI: 1568381978
Provider Name (Legal Business Name): PRERANA UPADHYA MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/11/2026
Last Update Date: 08/19/2026
Certification Date: 08/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6080 N LA CHOLLA BLVD SUITE B
TUCSON AZ
85741-3555
US

IV. Provider business mailing address

6080 N LA CHOLLA BLVD SUITE B
TUCSON AZ
85741-3555
US

V. Phone/Fax

Practice location:
  • Phone: 520-593-6875
  • Fax: 520-258-0583
Mailing address:
  • Phone: 520-593-6875
  • Fax: 520-258-0583

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License NumberR82838
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: