MEDICARE: CBAS CONSULTING INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QA0600X	Adult Day Care Clinic/Center

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1184207631
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CBAS CONSULTING INC

Provider Business Mailing Address
First Line	:	12385 JOLETTE AVE
Second Line	:
City	:	GRANADA HILLS
State	:	CA
Zip	:	91344-1633
Country	:	US
Telephone Number	:	951-221-5222
Fax Number	:

Provider Business Practice Location Address
First Line	:	854 JACKMAN ST
Second Line	:
City	:	EL CAJON
State	:	CA
Zip	:	92020-3053
Country	:	US
Telephone Number	:	818-404-5005
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	HAMBARSOOM REZKWA
Credential	:
Telephone Number	:	818-404-5005

Provider Enumeration Date	:	05/03/2021
Last Update Date	:	05/03/2021

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Directions to “CBAS CONSULTING INC ” Practice Location

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