Individual
CLETUS IBE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
1825 4TH ST FL 4, SAN FRANCISCO, CA 94143-2350
(415) 502-5577
Mailing address
1825 4TH ST FL 4, SAN FRANCISCO, CA 94143-2350
(415) 502-5577
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
008826
GA
363A00000X
Physician Assistant
Primary
54161
CA
Other
Enumeration date
11/26/2008
Last updated
05/25/2022
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