Provider Demographics
NPI:1649382698
Name:CHHAGANLAL, DINESH (MD)
Entity Type:Individual
Prefix:
First Name:DINESH
Middle Name:
Last Name:CHHAGANLAL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:315 MERCY AVE STE 400
Mailing Address - Street 2:
Mailing Address - City:MERCED
Mailing Address - State:CA
Mailing Address - Zip Code:95340
Mailing Address - Country:US
Mailing Address - Phone:209-564-3700
Mailing Address - Fax:209-564-3725
Practice Address - Street 1:315 MERCY AVE STE 400
Practice Address - Street 2:
Practice Address - City:MERCED
Practice Address - State:CA
Practice Address - Zip Code:95340
Practice Address - Country:US
Practice Address - Phone:209-564-3700
Practice Address - Fax:209-564-3725
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2015-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA105456207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
000000509797OtherANTHEM - NICC
000000556344OtherANTHEM - NLPCC
000000556344OtherANTHEM - NLPCC