Individual provider · Type 1 NPI
Myles Julian Ketchum, MD, PhD
Addiction Medicine (Family Medicine) Physician · Santa Rosa, CA
NPI number
1093249864
Active
Practice location
2360 Mendocino Ave
Santa Rosa, CA 95403-3153
Fax (707) 573-5458
Mailing address
PO Box 276950
Sacramento, CA 95827-6950
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Addiction Medicine (Preventive Medicine) Physician | 2083A0300X | 61-25999 (CA) |
| Addiction Medicine (Family Medicine) Physician Primary | 207QA0401X | 1211497 (CA) |
Addiction Medicine (Family Medicine) Physician: A family medicine physician who specializes in the diagnosis and treatment of addictions.
4 other providers at this address
- JP Medical Solutions, LLCDurable Medical Equipment & Medical Supplies Santa Rosa, CA NPI 1316126030
- Santa Rosa DentalGeneral Practice Dentistry Santa Rosa, CA NPI 1043309727
- Eugene G. Field, D.D.SDentist Santa-Rosa, CA NPI 1093988503
- Valarie Bochenek, NPEmergency Registered Nurse Santa Rosa, CA NPI 1962946293
Other addiction medicine (family medicine) physician providers in Santa Rosa
About NPI 1093249864
Myles Julian Ketchum, MD, PhD's National Provider Identifier is 1093249864, issued on Apr 18, 2017. The primary taxonomy on file is Addiction Medicine (Family Medicine) Physician (207QA0401X), and the practice location is in Santa Rosa, CA. The record was last updated on May 27, 2025.