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General NPI Number Information
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NPI Number | 1811152895
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Entity Type | Individual
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Provider Name | PUSHPASREE SAJJA MD
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Gender | Female
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Dates
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Enumeration Date | 07/19/2008
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Last Update Date | 07/19/2008
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Provider Practice Location Address
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Address Line | 1054 ARBOR RD #A
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City | MENLO PARK
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State | CA
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Zip | 94025-5026
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Country | US
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Telephone | 303-809-8983
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Fax | 303-845-9592
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Provider Business Mailing Address
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Address Line | 1054 ARBOR RD #A
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City | MENLO PARK
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State | CA
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Zip | 94025-5026
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Country | US
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Telephone | 303-809-8983
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Fax | 303-845-9592
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | C53288
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 36287
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License Number State | CO
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