Individual
JUNIOR WAKEFIELD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
4329 CENTRAL AVE APT 2, SAN DIEGO, CA 92105-1158
(619) 635-8011
Mailing address
4329 CENTRAL AVE APT 2, SAN DIEGO, CA 92105-1158
(619) 635-8011
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
—
—
Other
Enumeration date
06/17/2020
Last updated
06/22/2020
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