Individual provider Active NPI

Kanchana R Viswanathan, MD

  • Endocrinology, Diabetes & Metabolism Physician
  • Long Beach, CA
National Provider Identifier
1760491104
Registry record updated Aug 12, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
License
C53345 Issued in CA
Practice address
1868 Pacific Ave
Long Beach, CA 90806-6113
Phone
(562) 595-4718
NPI assigned
Aug 5, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2013

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endocrinology, Diabetes & Metabolism Physician 207RE0101X C53345 CA Primary

Addresses

Primary practice location

1868 Pacific Ave
Long Beach, CA 90806-6113

Mailing address

1868 Pacific Ave
Long Beach, CA 90806-6113

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130509000444 CA Practitioner - Endocrinology 9436227550 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Endocrinology
Education
Other, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

1760 Termino Ave
Suite 214
Long Beach, CA 90804-2169
Phone (562) 595-4718

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Prohealth Partners a Medical Group Inc CurrentSince May 7, 2014 Accepting new patients
Prohealth Partners, a Medical Group, Inc. CurrentSince May 7, 2014 Accepting new patients
Prohealth Partners, a Medical Group Current Accepting new patients
Prohealth Partners, a Medical Group, Inc. Past Accepting new patients
Tele-Medicine Services Ny, PLLC PastSince Apr 27, 2025 Accepting new patients
Long Beach Memorial Medical Past Accepting new patients
Beloit Health System Inc Past Accepting new patients
Dignity Health Past Accepting new patients
St. Mary Medical Center Past Accepting new patients

Locations

5750 Downey Ave
Ste 100
Lakewood, CA 90712
Phone (562) 630-3105

1760 Termino Ave
Ste 214
Long Beach, CA 90804
Phone (562) 595-4718

3801 Katella Ave
Ste 330
Los Alamitos, CA 90720
Phone (562) 594-9546

File 54567
Los Angeles, CA 90074
Phone (310) 491-9060

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 9

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1154736000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1376265600000",
    "number": "1760491104",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1868 PACIFIC AVE",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908066113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1868 PACIFIC AVE",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908066113",
            "telephone_number": "562-595-4718"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VISWANATHAN",
        "first_name": "KANCHANA",
        "middle_name": "R",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-05",
        "last_updated": "2013-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "CA",
            "license": "C53345",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Long Beach, CA

Sources for this page

Verify at the official NPI Registry.