Organization
JEFFRY WU O.D. PROFESSIONAL CORPORATION
Active
Other names
State Street Optometry
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JEFFRY WU OD (PRESIDENT)
(909) 792-2280
Entity
Organization
Contact information
Practice address
112 E STATE ST, REDLANDS, CA 92373-4756
(909) 792-2280
(909) 792-4872
Mailing address
112 E STATE ST, REDLANDS, CA 92373-4756
(909) 792-2280
(909) 792-4872
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
15020
CA
152WC0802X
Corneal and Contact Management Optometrist
15020
CA
152WP0200X
Pediatric Optometrist
15020
CA
152WX0102X
Occupational Vision Optometrist
15020
CA
Other
Enumeration date
11/15/2017
Last updated
07/20/2020
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