Healthcare Provider Details

I. General information

NPI: 1417861626
Provider Name (Legal Business Name): YUSRA PASHA DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/02/2026
Last Update Date: 10/02/2026
Certification Date: 10/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 W 16TH ST
PUEBLO CO
81003-2781
US

IV. Provider business mailing address

3119 E SPAULDING AVE
PUEBLO CO
81008-5201
US

V. Phone/Fax

Practice location:
  • Phone: 719-595-7585
  • Fax: 719-595-7589
Mailing address:
  • Phone: 719-595-7585
  • Fax: 719-595-7589

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberTL.0011635
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: