Patricia Marie Kettlehake

MD | Pediatrics | Female

Patricia Marie Kettlehake, MD is a Coronado, California based Pediatric doctor with medical specialization in General Pediatrics. Current practice location of Patricia Marie Kettlehake is 230 Prospect Pl, Ste 220, Coronado, California - 92118-1978. She can be contacted on phone at 619-435-2670. Patricia Marie Kettlehake is a sole proprietor of her business.
NPI number (Unique professional ID) for Patricia Marie Kettlehake is 1831109982 which was assigned by NPPES on 09 Aug, 2006 and it was last updated on 19 Oct, 2017. Patricia Marie Kettlehake license number is A68312 for Pediatrics (208000000X) in California.
Patricia Marie Kettlehake is a pediatrician who is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.
Complete Profile:
Patricia Marie Kettlehake basic information including her official name, gender, specialization, credentials etc. are as mentioned below.
Specialization :Pediatrics
Provider Name :Patricia Marie Kettlehake
Credential :MD
Gender :Female
Business Address:
Patricia Marie Kettlehake address, contact phone number and fax are as below. Patients can directly walkin to the clinic or can call on the below given phone number for appointment.
Primary Address :230 Prospect Pl, Ste 220
Coronado, CA, 92118-1978
United States
Phone Number :619-435-2670
Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). NPI details are as mentioned below.
NPI Number : 1831109982
NPI Entity Type : Individual
First Enrolment Date : 09 Aug, 2006
Last Updated On : 19 Oct, 2017
Medicare Participation:
Patricia Marie Kettlehake participates in medicare and accepts medicare insurance either directly or through association with group practice or medical facility.
Medicare PECOS ID :4385687938
Medicare Enrollment ID :I20050606000546
Primary Specialty :Internal Medicine
Medical School :University Of Toledo College Of Medicine
Graduation Year :1995
Accepts Medicare?Yes. Patricia Marie Kettlehake accepts medicare insurance.
Group Practice Association:
Patricia Marie Kettlehake is associated with following Group Practice Organizations. Group practices are practice of medicine by a group of physicians who share their premises and other resources. Following list states all the group name with which Patricia Marie Kettlehake is associated with along with the number of members in that group. She may also accept medicare indirectly via these group practices.
Organisation Name :Group Practice IDNo. of MembersPractice AddressGroup Accepts Medicare
230 Prospect Pl
Suite 220
Coronado, CA - 921181978
Ph: 6194352670
May accept
Licenses and Specialities:
Physicians/Organizations can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Patricia Marie Kettlehake are as mentioned. Primary taxonomy code for Patricia Marie Kettlehake, MD is 208000000X (Pediatrics).
Taxonomy Code SpecialityPrimaryLicense No.State
207R00000XInternal MedicineNoA68312CA
208000000XPediatricsYesA68312CA
Legacy Identifiers:
Other legacy medical identifiers of Patricia Marie Kettlehake such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned below.
IdentifierIdentifier TypeStateIssuer
00A683120MEDICAIDCA
Mailing Address:
Mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned business address only.
Mailing Address :230 Prospect Pl, Ste 220
Coronado, CA, 92118-1978
United States
Phone Number :619-435-2670
Business Location:
Patients can refer following map for directions to Patricia Marie Kettlehake practice address. Don't forget to take prior appointment before visiting.

** Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES.