Myles Julian Ketchum, MD, PHD
Myles Julian Ketchum, MD, PHD is a Family Practice in Santa Rosa, California. Graduated from Louisiana State University School of Medicine in New Orleans in 2017, 9 years ago. Practices with Shasta Community Health Center, a 63-clinician group, accepts Medicare assignment and offers telehealth. Licensed in California.
- Years since qualifying
- 9
- Trained at
- Louisiana State University School of Medicine in New Orleans
- Licensed in
- CA
- In the registry since
- 2017
- Specialties on file
- 2
What do these letters mean?
Practice location Address checks out
2360 Mendocino AveSanta Rosa, CA 95403-3153
Phone: (707) 573-5250
Fax: (707) 573-5458
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Addiction Medicine (Family Medicine) Physician (primary) | Taxonomy 207QA0401X · Licence 1211497 (CA) |
|---|---|
| Addiction Medicine (Preventive Medicine) Physician | Taxonomy 2083A0300X · Licence 61-25999 (CA) |
Record details
| NPI number | 1093249864 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Male |
| Credentials | MD , PHD |
| Sole proprietor | Yes |
| NPI enumerated | April 18, 2017 |
| Last updated in NPPES | May 27, 2025 |
| Certification date | May 27, 2025 |
Medicare enrollment
| Medicare specialty | FAMILY PRACTICE |
|---|---|
| Medical school | LOUISIANA STATE UNIVERSITY SCHOOL OF MEDICINE IN NEW ORLEANS |
| Graduated | 2017 (9 years in practice) |
| Group practice | Shasta Community Health Center — 63 clinicians |
| Accepts Medicare assignment | Yes — accepts the Medicare-approved amount |
| Telehealth | Offers telehealth services |
| Practice locations | 2 on file with Medicare |