Provider Demographics
NPI:1174647713
Name:BRATCHER, BEN PETER (RD)
Entity Type:Individual
Prefix:MR
First Name:BEN
Middle Name:PETER
Last Name:BRATCHER
Suffix:
Gender:M
Credentials:RD
Other - Prefix:MR
Other - First Name:BENJAMIN
Other - Middle Name:PETER
Other - Last Name:BRATCHER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RD
Mailing Address - Street 1:9400 ROSECRANS AVE
Mailing Address - Street 2:
Mailing Address - City:BELLFLOWER
Mailing Address - State:CA
Mailing Address - Zip Code:90706-2246
Mailing Address - Country:US
Mailing Address - Phone:562-461-4339
Mailing Address - Fax:
Practice Address - Street 1:9400 ROSECRANS AVE
Practice Address - Street 2:
Practice Address - City:BELLFLOWER
Practice Address - State:CA
Practice Address - Zip Code:90706-2246
Practice Address - Country:US
Practice Address - Phone:562-461-4339
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered