Provider Demographics
NPI:1568864239
Name:ABSOLUTE BEST MEDICAL PRACTICE INC
Entity Type:Organization
Organization Name:ABSOLUTE BEST MEDICAL PRACTICE INC
Other - Org Name:RAVINDRANATH V SHAHANE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RAVINDRANATH
Authorized Official - Middle Name:
Authorized Official - Last Name:SHAHANE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:909-875-3595
Mailing Address - Street 1:1734 N RIVERSIDE AVE
Mailing Address - Street 2:STE #2
Mailing Address - City:RIALTO
Mailing Address - State:CA
Mailing Address - Zip Code:92376-8058
Mailing Address - Country:US
Mailing Address - Phone:909-875-3595
Mailing Address - Fax:
Practice Address - Street 1:1734 N RIVERSIDE AVE
Practice Address - Street 2:STE #2
Practice Address - City:RIALTO
Practice Address - State:CA
Practice Address - Zip Code:92376-8058
Practice Address - Country:US
Practice Address - Phone:909-875-3595
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-24
Last Update Date:2014-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA87056261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAI22950Medicare UPIN