MEDICARE: IVANA VIANI 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	174400000X	Specialist	174432	CA
2	2084P0800X	Psychiatry Physician	174432	CA

General Provider Information

NPI Number	:	1942704705
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	IVANA VIANI MD

Provider Business Mailing Address
First Line	:	10850 WILSHIRE BLVD STE 850
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90024-4608
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	10850 WILSHIRE BLVD STE 850
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90024-4608
Country	:	US
Telephone Number	:	310-806-3511
Fax Number	:

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

Provider Enumeration Date	:	03/19/2018
Last Update Date	:	04/24/2024

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Directions to “ IVANA VIANI MD” Practice Location

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