Provider Demographics
NPI:1184207631
Name:CBAS CONSULTING INC
Entity Type:Organization
Organization Name:CBAS CONSULTING INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:HAMBARSOOM
Authorized Official - Middle Name:
Authorized Official - Last Name:REZKWA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-404-5005
Mailing Address - Street 1:12385 JOLETTE AVE
Mailing Address - Street 2:
Mailing Address - City:GRANADA HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91344-1633
Mailing Address - Country:US
Mailing Address - Phone:951-221-5222
Mailing Address - Fax:
Practice Address - Street 1:854 JACKMAN ST
Practice Address - Street 2:
Practice Address - City:EL CAJON
Practice Address - State:CA
Practice Address - Zip Code:92020-3053
Practice Address - Country:US
Practice Address - Phone:818-404-5005
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-03
Last Update Date:2021-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA09042001Medicaid