Provider Demographics
NPI:1871934778
Name:CHOGLE, ISHWAREE RAJIV (MD)
Entity type:Individual
Prefix:DR
First Name:ISHWAREE
Middle Name:RAJIV
Last Name:CHOGLE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1939 ACADEMY AVE
Mailing Address - Street 2:
Mailing Address - City:SANGER
Mailing Address - State:CA
Mailing Address - Zip Code:93657-3737
Mailing Address - Country:US
Mailing Address - Phone:559-875-6900
Mailing Address - Fax:
Practice Address - Street 1:1939 ACADEMY AVE
Practice Address - Street 2:
Practice Address - City:SANGER
Practice Address - State:CA
Practice Address - Zip Code:93657
Practice Address - Country:US
Practice Address - Phone:559-875-6900
Practice Address - Fax:559-875-6011
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-09
Last Update Date:2018-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA147796207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty