MEDICARE: RITU JAIN VISWANATH MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	ME120655	FL
2	207R00000X	Internal Medicine Physician	A125466	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	14W11	OTHER	FL	BLUE CROSS BLUE SHIELD

General Provider Information

NPI Number	:	1497029078
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RITU JAIN VISWANATH MD

Provider Business Mailing Address
First Line	:	10573 W PICO BLVD # 822
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90064-2333
Country	:	US
Telephone Number	:	310-571-5015
Fax Number	:

Provider Business Practice Location Address
First Line	:	10573 W PICO BLVD # 822
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90064-2333
Country	:	US
Telephone Number	:	310-571-5015
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/29/2012
Last Update Date	:	08/17/2022

Similar Medicare Providers

1124025432 — SANDERS PHARMACEUTICALS INC
Practice Location Address:

10587 W PICO BLVD , SUITE A
LOS ANGELES, CA
90064-2333

Practice Phone: 310-475-3541
Practice Fax: 310-474-3323

1821179896 — ELIZABETH BAILLIE DPT
Practice Location Address:

10573 W PICO BLVD # 354
LOS ANGELES, CA
90064-2333

Practice Phone: 424-438-1426
Practice Fax:

1538359245 — KAYE MARIE GORNALL RPH
Practice Location Address:

10569 W PICO BLVD
LOS ANGELES, CA
90064-2333

Practice Phone: 310-475-3541
Practice Fax:

1760675110 — DR. ALEXIS DANIEL HAKIM M.D.
Practice Location Address:

10573 W PICO BLVD # 207
LOS ANGELES, CA
90064-2333

Practice Phone: 213-267-5337
Practice Fax: 424-330-2377

1093909178 — DR. MARJAN NIKKA YERMIAN PHARM.D.
Practice Location Address:

10569 W PICO BLVD
LOS ANGELES, CA
90064-2333

Practice Phone: 310-475-3541
Practice Fax: 310-474-3323

1194914689 — PARK LANE GLOBAL INC.
Practice Location Address:

10573 W PICO BLVD , 221
LOS ANGELES, CA
90064-2333

Practice Phone: 310-466-3738
Practice Fax: 310-967-0121

Directions to “ RITU JAIN VISWANATH MD” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.