Individual
DIVYA CHODE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D
Contact information
Practice address
1310 W STEWART DR, STE 410, ORANGE, CA 92868-3854
(714) 639-9401
Mailing address
1310 W STEWART DR, STE 410, ORANGE, CA 92868-3854
(714) 639-9401
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
A33378
CA
208M00000X
Hospitalist Physician
Primary
A33378
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1912919804
TYPE 2 NPI
CA
01
—
A133378
MEDICAL LICENSE
CA
01
—
CG5665
RAILROAD MEDICARE GROUP PTAN
CA
01
—
P01615369
RAILROAD MEDICARE PROVIDER PTAN
CA
Enumeration date
10/12/2011
Last updated
10/21/2020
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