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Individual

KEVIN KETSAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
NP

Contact information

Practice address
2414 S. FAIRVIEW ST., SUITE 212, SANTA ANA, CA 92704
(877) 830-7328
(877) 830-7469
Mailing address
3025 MARY CMN, SANTA ANA, CA 92703-3474
(877) 830-7328
(877) 830-7469

Taxonomy

Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
95000775
CA

Other

Enumeration date
03/03/2015
Last updated
03/03/2015
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