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 |
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| Provider Name : | Patricia Marie Kettlehake |
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| Credential : | MD |
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| Gender : | Female |
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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 |
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| Phone Number : | 619-435-2670 |
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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 |
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| NPI Entity Type : | Individual |
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| First Enrolment Date : | 09 Aug, 2006 |
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| Last Updated On : | 19 Oct, 2017 |
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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 |
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| Medicare Enrollment ID : | I20050606000546 |
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| Primary Specialty : | Internal Medicine |
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| Medical School : | University Of Toledo College Of Medicine |
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| Graduation Year : | 1995 |
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| Accepts Medicare? | Yes. Patricia Marie Kettlehake accepts medicare insurance. |
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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 ID | No. of Members | Practice Address | Group 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 | Speciality | Primary | License No. | State |
|---|
| 207R00000X | Internal Medicine | No | A68312 | CA |
| 208000000X | Pediatrics | Yes | A68312 | CA |
Legacy Identifiers:
Other legacy medical identifiers of Patricia Marie Kettlehake such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned below.
| Identifier | Identifier Type | State | Issuer |
|---|
| 00A683120 | MEDICAID | CA | |
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 |
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| Phone Number : | 619-435-2670 |
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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. Last updated on 08 January, 2024.