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Individual
PATRICIA MARIE KETTLEHAKE
Active
Individual
PATRICIA MARIE KETTLEHAKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
A68312
CA
208000000X
Pediatrics Physician
Primary
A68312
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A683120
—
CA
Enumeration date
08/09/2006
Last updated
10/19/2017
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