# JEFFREY P WASSERSTROM MD A MEDICAL CORPORATION

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1225304108
- **Authorized official:** DR. JEFFREY P WASSERSTROM MD (PRESIDENT)
- **Authorized official phone:** (619) 698-1088

## Contact information

- **Practice address:** 5565 GROSSMONT CENTER DR, BLDG 3 SUITE 551, LA MESA, CA 91942-3020
- **Practice address phone:** (619) 698-1088
- **Practice address fax:** (619) 698-1189
- **Mailing address:** 5565 GROSSMONT CENTER DR, BLDG 3 SUITE 551, LA MESA, CA 91942-3020
- **Mailing address phone:** (619) 698-1088
- **Mailing address fax:** (619) 698-1189

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207W00000X | Ophthalmology Physician | G54813 | CA | Yes |

## Other

- **Enumeration date:** 03/26/2012
- **Last updated:** 04/10/2012