MEDICARE: DR. MICHAEL RATENER M.D.

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	2084P0800X	Psychiatry Physician	G421473	CA

General Provider Information

NPI Number	:	1518048628
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MICHAEL RATENER M.D.

Provider Business Mailing Address
First Line	:	2914 DOMINGO AVE
Second Line	:	SUITE B
City	:	BERKELEY
State	:	CA
Zip	:	94705-2454
Country	:	US
Telephone Number	:	510-981-0800
Fax Number	:	510-981-8440

Provider Business Practice Location Address
First Line	:	2914 DOMINGO AVE
Second Line	:	SUITE B
City	:	BERKELEY
State	:	CA
Zip	:	94705-2454
Country	:	US
Telephone Number	:	510-981-0800
Fax Number	:	510-981-8440

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/17/2006
Last Update Date	:	12/19/2008

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