Provider Demographics
NPI:1316476484
Name:RAMAKRISHNAN, RITHIKA (MD)
Entity type:Individual
Prefix:DR
First Name:RITHIKA
Middle Name:
Last Name:RAMAKRISHNAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1040 ELM AVE STE 303
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90813-3267
Mailing Address - Country:US
Mailing Address - Phone:562-684-2560
Mailing Address - Fax:
Practice Address - Street 1:1040 ELM AVE STE 303
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90813-3267
Practice Address - Country:US
Practice Address - Phone:562-684-2560
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-12
Last Update Date:2024-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA173190207RI0200X
PAMD470234207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAMT213847Medicaid