Provider Demographics
NPI:1821001496
Name:RATINER, BORIS D (MD)
Entity Type:Individual
Prefix:DR
First Name:BORIS
Middle Name:D
Last Name:RATINER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18386 VENTURA BLVD
Mailing Address - Street 2:
Mailing Address - City:TARZANA
Mailing Address - State:CA
Mailing Address - Zip Code:91356-4219
Mailing Address - Country:US
Mailing Address - Phone:818-996-4077
Mailing Address - Fax:818-996-4069
Practice Address - Street 1:18386 VENTURA BLVD
Practice Address - Street 2:
Practice Address - City:TARZANA
Practice Address - State:CA
Practice Address - Zip Code:91356-4219
Practice Address - Country:US
Practice Address - Phone:818-996-4077
Practice Address - Fax:818-996-4069
Is Sole Proprietor?:No
Enumeration Date:2006-08-14
Last Update Date:2023-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA60202207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A602020Medicaid
CA00A602020Medicaid
CAWA71626BMedicare ID - Type UnspecifiedINDIVIDUAL PROVIDER