Provider Demographics
NPI:1700999117
Name:BORIS D RATINER, MD, INC
Entity Type:Organization
Organization Name:BORIS D RATINER, MD, INC
Other - Org Name:RHEUMATOLOGY THERAPEUTICS MEDICAL CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:DIANA
Authorized Official - Middle Name:
Authorized Official - Last Name:BABAYANTS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-996-4077
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
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-17
Last Update Date:2023-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA60202207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAW16531Medicare ID - Type UnspecifiedMEDICARE GROUP
CA4139380001Medicare NSC