Provider Demographics
NPI:1326213034
Name:MICHAEL RATTER, M.D., A PROFESSIONAL CORPORATION
Entity Type:Organization
Organization Name:MICHAEL RATTER, M.D., A PROFESSIONAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:LEONARD
Authorized Official - Last Name:RATTER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:951-658-4903
Mailing Address - Street 1:9619 CHESAPEAKE DR
Mailing Address - Street 2:SUITE 102
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92123-1368
Mailing Address - Country:US
Mailing Address - Phone:858-279-1212
Mailing Address - Fax:858-279-1420
Practice Address - Street 1:9619 CHESAPEAKE DR
Practice Address - Street 2:SUITE 102
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92123-1368
Practice Address - Country:US
Practice Address - Phone:858-279-1212
Practice Address - Fax:858-279-1420
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-23
Last Update Date:2008-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG56347207P00000X, 208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Multi-Specialty
No208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty