Individual
DR. JEFFREY PHILLIP WASSERSTROM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
5565 GROSSMONT CENTER DR, BLDG. 3 SUITE 551, LA MESA, CA 91942-3020
(619) 698-1088
(619) 698-1189
Mailing address
5565 GROSSMONT CENTER DR, BLDG. 3 SUITE 551, LA MESA, CA 91942-3020
(619) 698-1088
(619) 698-1189
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
G54813
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G548130
—
CA
Enumeration date
06/17/2006
Last updated
02/06/2014
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