Individual
DR. CHERYL KETNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DC
Contact information
Practice address
276 VICTORIA ST, COSTA MESA, CA 92627-1989
(949) 642-9355
Mailing address
276 VICTORIA ST, COSTA MESA, CA 92627-1989
(949) 642-9355
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
DC 26750
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1528249927
NPI FOR CORPORATION
CA
01
—
W19565
GROUP PROVIDER NUMBER
CA
Enumeration date
07/18/2006
Last updated
09/24/2008
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