Wake, Jerry Stanley

Wake, Jerry Stanley is an individual health care provider with primary practice located at 1630 W Redondo Beach Blvd Suite #1, Gardena CA 90247-3200. He recently has 2 registered licenses in different health care specialties including Eye and Vision Services Providers / Optometrist, Eye and Vision Services Providers / Corneal and Contact Management. Eye and Vision Services Providers / Optometrist is his primary health care specialty. Wake, Jerry Stanley can be contacted via phone (310) 324-8205.

Contact Information

Primary practice address
1630 W Redondo Beach Blvd Suite #1 Gardena CA 90247-3200
Phone: (310) 324-8205
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X 5790T California
Eye and Vision Services Providers / Corneal and Contact Management 152WC0802X 5790T California

Profile Details

NPI number 1013033059
LBN Legal business name Wake, Jerry Stanley
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 21st, 2007
Last updated May 2nd, 2014 - about 11 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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