Organization
MARSHALL B. KETCHUM UNIVERSITY
Active
Other names
Ketchum Health Medical Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRANDON GROVE MD (DIRECTOR OF MEDICAL CLINICS)
(714) 992-7818
Entity
Organization
Contact information
Practice address
5460 E LA PALMA AVE, ANAHEIM, CA 92807-2023
(714) 463-7500
Mailing address
5460 E LA PALMA AVE, ANAHEIM, CA 92807-2023
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
—
—
207Q00000X
Family Medicine Physician
—
—
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
363A00000X
Physician Assistant
—
—
363L00000X
Nurse Practitioner
—
—
Other
Enumeration date
11/22/2017
Last updated
01/18/2024
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