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Individual

DR. JERRY WILLIAM VLASAK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
100 W CALIFORNIA BLVD, TRAUMA SERVICES, PASADENA, CA 91105-3010
(310) 251-0259
(213) 477-2306
Mailing address
556 S FAIR OAKS AVE, SUITE 101, #25, PASADENA, CA 91105-2656
(310) 251-0259
(213) 477-2306

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
A042683
CA
2086S0127X
Trauma Surgery Physician
Primary
A042683
CA

Other

Enumeration date
06/16/2006
Last updated
12/27/2013
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