MARSHALL B. KETCHUM UNIVERSITY NPI 1174037493

NPI Information

  • NPI: 1174037493
  • Provider Name: MARSHALL B. KETCHUM UNIVERSITY
  • Classification: Clinic/Center - 261QM1300X
  • Specialization: Multi-Specialty
  • Entity Type: Organization
  • Doing Business As: KETCHUM HEALTH MEDICAL CLINIC
  • Address: 5460 E LA PALMA AVE
    ANAHEIM, CA
    ZIP 92807
  • Phone: (714) 463-7500

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NPI Details

MARSHALL B. KETCHUM UNIVERSITY is a multi-specialty clinic center in Anaheim, CA. MARSHALL B. KETCHUM UNIVERSITY NPI is 1174037493. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Ketchum Health Medical Clinic.

The provider's business location address is:

5460 E LA PALMA AVE
ANAHEIM, CA
ZIP 92807-023
Phone: (714) 463-7500

The provider's authorized official is Brandon Grove .
The authorized official title is Director Of Medical Clinics and has the following contact phone number (714) 992-7818.

The enumeration date for this NPI number is 11/22/2017 and was last updated on 1/18/2024.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1183500000XPharmacistNo
2207Q00000XFamily MedicineNo
3363A00000XPhysician AssistantNo
4363L00000XNurse PractitionerNo
5261QM1300XClinic/CenterMulti-SpecialtyYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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