Provider Demographics
NPI:1518453422
Name:GOGTE, PRIYANKA VISHWANATH (MD)
Entity Type:Individual
Prefix:
First Name:PRIYANKA
Middle Name:VISHWANATH
Last Name:GOGTE
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:PO BOX 4249
Mailing Address - Street 2:
Mailing Address - City:WHITTIER
Mailing Address - State:CA
Mailing Address - Zip Code:90607-4249
Mailing Address - Country:US
Mailing Address - Phone:562-696-9265
Mailing Address - Fax:877-887-8750
Practice Address - Street 1:12462 PUTNAM ST STE 506
Practice Address - Street 2:
Practice Address - City:WHITTIER
Practice Address - State:CA
Practice Address - Zip Code:90602-1049
Practice Address - Country:US
Practice Address - Phone:562-698-8141
Practice Address - Fax:562-698-9885
Is Sole Proprietor?:No
Enumeration Date:2018-07-03
Last Update Date:2023-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA174257207RN0300X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology