Individual
DR. DAVID ALOYSIUS KETELAAR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1400 E CHURCH ST, SANTA MARIA, CA 93454-5906
(805) 739-3200
(805) 739-3064
Mailing address
4401 W MEMORIAL ROAD, SUITE 121, OKLAHOMA CITY, OK 73134-1722
(405) 751-4664
(405) 751-4561
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
G77236
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G772360
—
CA
Enumeration date
07/03/2006
Last updated
09/09/2010
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