Healthcare Provider Details

I. General information

NPI: 1952613036
Provider Name (Legal Business Name): UPAMA BARUA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/06/2010
Last Update Date: 12/10/2024
Certification Date: 12/10/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5925 W LAS POSITAS BLVD
PLEASANTON CA
94588-8537
US

IV. Provider business mailing address

5925 W LAS POSITAS BLVD STE 100
PLEASANTON CA
94588-8537
US

V. Phone/Fax

Practice location:
  • Phone: 925-462-1755
  • Fax:
Mailing address:
  • Phone: 925-462-1755
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberA139578
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: