Healthcare Provider Details

I. General information

NPI: 1821910738
Provider Name (Legal Business Name): PUJA UPADHYAYA PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/30/2026
Last Update Date: 09/03/2026
Certification Date: 09/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6301 W 38TH AVE
WHEAT RIDGE CO
80033-5057
US

IV. Provider business mailing address

6301 W 38TH AVE
WHEAT RIDGE CO
80033-5057
US

V. Phone/Fax

Practice location:
  • Phone: 720-710-2983
  • Fax:
Mailing address:
  • Phone: 720-600-9045
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA.0010014
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: