Organization
JACK WAX, M.D., INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JACK WAX M.D. (PRESIDENT-SOLE OWNER)
(818) 888-7815
Entity
Organization
Contact information
Practice address
2080 CENTURY PARK E, LOS ANGELES, CA 90067-2001
(310) 277-1846
Mailing address
PO BOX 7001, TARZANA, CA 91357-7001
(818) 888-7815
(818) 715-1722
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
A28870
CA
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
A28870
CA
Other
Enumeration date
11/20/2006
Last updated
09/11/2025
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