Individual
MATHEW WILLIAM CARVER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
126 E 16TH ST, COSTA MESA, CA 92627-7704
(949) 940-5445
Mailing address
126 E 16TH ST, COSTA MESA, CA 92627-7704
(949) 940-5445
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
235524
CA
261QM0850X
Adult Mental Health Clinic/Center
Primary
235524
CA
Other
Enumeration date
05/31/2018
Last updated
05/31/2018
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