Healthcare Provider Details

I. General information

NPI: 1700999117
Provider Name (Legal Business Name): BORIS D RATINER, MD, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/17/2006
Last Update Date: 03/19/2025
Certification Date: 03/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18386 VENTURA BLVD
TARZANA CA
91356-4219
US

IV. Provider business mailing address

18386 VENTURA BLVD
TARZANA CA
91356-4219
US

V. Phone/Fax

Practice location:
  • Phone: 818-996-4077
  • Fax: 818-996-4069
Mailing address:
  • Phone: 818-996-4077
  • Fax: 818-996-4069

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332900000X
TaxonomyNon-Pharmacy Dispensing Site
License Number
License Number State

VIII. Authorized Official

Name: DIANA BABAYANTS
Title or Position: OFFICE MANAGER
Credential:
Phone: 818-996-4077