Marshall B. Ketchum University

NPI #1720101876 in Anaheim, California

Provider Information

NPI Number: 1720101876
Entity Type: Organization
Organization Name: Marshall B. Ketchum University
Primary Specialty: Optometrist
Enumeration Date: Apr 6, 2007
Last Updated: Sep 20, 2016

Practice Location

Address: 5460 E LA PALMA AVE
City: Anaheim
State: California
ZIP Code: 92807-2023
Phone: (714) 463-7500

Authorized Official

Name: MARK NAKANO, O.D.
Title: ASSOCIATE DEAN OF CLINICS
Phone: (714) 463-7504

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Optometrist	152W00000X	Primary

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