Provider Demographics
NPI:1841614963
Name:ARIBA HEALTHCARE GROUP INC.
Entity Type:Organization
Organization Name:ARIBA HEALTHCARE GROUP INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TARIQ
Authorized Official - Middle Name:
Authorized Official - Last Name:MIRZA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:510-754-0729
Mailing Address - Street 1:37553 FREMONT BLVD
Mailing Address - Street 2:
Mailing Address - City:FREMONT
Mailing Address - State:CA
Mailing Address - Zip Code:94536-3706
Mailing Address - Country:US
Mailing Address - Phone:510-797-1051
Mailing Address - Fax:510-797-1157
Practice Address - Street 1:696 E SANTA CLARA ST
Practice Address - Street 2:SUITE 202
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95112-1911
Practice Address - Country:US
Practice Address - Phone:408-292-9404
Practice Address - Fax:408-292-9476
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-02-10
Last Update Date:2014-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA84987302F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302F00000XManaged Care OrganizationsExclusive Provider Organization
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAI00836Medicare UPIN