Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
DR. JACK KENNETH DEITCHMAN, MD
ActiveDR. JACK KENNETH DEITCHMAN, MD is a Preventive Medicine healthcare provider located in GRASS VALLEY, California. NPI 1346254141 is currently active in the NPPES registry. Verify at CMS.
Preventive Medicine · GRASS VALLEY, CA
Registration Details
- NPI Number
- 1346254141
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Jul 28, 2006 (20.067993076568 yrs)
- Last Updated
- Mar 5, 2009
- License
-
G26297 (CA)
Practice Information
- Address
-
140 LITTON DRIVESUITE 110GRASS VALLEY, CA, 95945Browse CA providers · Browse ZIP 95945
- Phone
- 5302748483
- Fax
- 5302712067
- Primary Specialty
-
Preventive Medicine
2083P0500X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.