Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Dr. Michael Ketelaar, MD

Individual provider Surgery Physician · NPI 1487705935

Dr. Michael Ketelaar, MD is a Surgery Physician in Lodi, California. Practices as a sole proprietor. Licensed in California.

Licensed in
CA
In the registry since
2007
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

See every abbreviation used in this directory →

Practice location Address checks out

1231 W Vine St
Lodi, CA 95240-5109
Phone: (209) 368-7121
Fax: (209) 368-5750
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Surgery Physician (primary) Taxonomy 208600000X · Licence C39467 (CA)

Record details

NPI number1487705935
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorYes
NPI enumeratedJanuary 12, 2007
Last updated in NPPESJune 17, 2009
Mailing address1231 W Vine St, Lodi, CA 95240-5109

Other providers in Lodi