Provider Demographics
NPI:1609518935
Name:READ, BENJAMIN (RD)
Entity Type:Individual
Prefix:
First Name:BENJAMIN
Middle Name:
Last Name:READ
Suffix:
Gender:M
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19 SANTA CATALINA
Mailing Address - Street 2:
Mailing Address - City:RANCHO SANTA MARGARITA
Mailing Address - State:CA
Mailing Address - Zip Code:92688-2530
Mailing Address - Country:US
Mailing Address - Phone:949-872-8419
Mailing Address - Fax:
Practice Address - Street 1:19 SANTA CATALINA
Practice Address - Street 2:
Practice Address - City:RANCHO SANTA MARGARITA
Practice Address - State:CA
Practice Address - Zip Code:92688-2530
Practice Address - Country:US
Practice Address - Phone:949-872-8419
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-07
Last Update Date:2022-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered