Individual
ERIK CHRISTIAN KETELSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
IDC
Contact information
Practice address
4653 DOCK RD, BLDG 524, PORT HUENEME, CA 93043-4321
(619) 534-7920
Mailing address
18 ALISO LN, VENTURA, CA 93001-3214
Taxonomy
Speciality
Code
Description
License number
State
1710I1002X
Independent Duty Corpsman
Primary
—
—
Other
Enumeration date
12/01/2009
Last updated
12/01/2009
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