Individual
CARL DEWITTE MEBANE JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
111 MYRTLE ST, 102, OAKLAND, CA 94607-2525
(510) 839-3800
Mailing address
362 EUCLID AVE APT 107, OAKLAND, CA 94610-3239
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
12/03/2013
Last updated
12/03/2013
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