Myles Ketchum, M.D., PH.D

NPI 1093249864 · on the registry since 2017 · sole proprietor

Practice

Address: 2360 Mendocino Ave
Santa Rosa, CA 95403
Phone: (707) 573-5250
Fax: (707) 573-5458
Organisation at this address: Santa Rosa Dental
Jp Medical Solutions, Llc
Inferred from a shared address, not stated in the registry.
Clinicians at this address: 3

Registry record

Primary taxonomy: 207QA0401X
207QA0401X
Also registered as: 2083A0300X
Licence states on file: CA
From the registry's licence fields, which are often incomplete.
Sex: Male
Record last updated: 2025-05-27

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in California