Provider Demographics
NPI:1811152895
Name:SAJJA, PUSHPASREE (MD)
Entity type:Individual
Prefix:DR
First Name:PUSHPASREE
Middle Name:
Last Name:SAJJA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:SREE
Other - Middle Name:
Other - Last Name:SAJJA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:1054 ARBOR RD
Mailing Address - Street 2:#A
Mailing Address - City:MENLO PARK
Mailing Address - State:CA
Mailing Address - Zip Code:94025-5026
Mailing Address - Country:US
Mailing Address - Phone:303-809-8983
Mailing Address - Fax:303-845-9592
Practice Address - Street 1:1054 ARBOR RD
Practice Address - Street 2:#A
Practice Address - City:MENLO PARK
Practice Address - State:CA
Practice Address - Zip Code:94025-5026
Practice Address - Country:US
Practice Address - Phone:303-809-8983
Practice Address - Fax:303-845-9592
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-19
Last Update Date:2008-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC53288207R00000X
CO36287207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine