Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Dr. Jerry Stanley Wake, OD

Individual provider Optometrist · NPI 1013033059

Dr. Jerry Stanley Wake, OD is an Optometrist in Gardena, California. Licensed in California. Registered with an NPI since 2007.

Licensed in
CA
In the registry since
2007
Specialties on file
2
What do these letters mean?
OD — Doctor of Optometry
An optometrist: examines eyes, prescribes glasses and contacts, and treats many eye conditions.

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Practice location Address checks out

1630 W Redondo Beach Blvd Ste #1
Gardena, CA 90247-3200
Phone: (310) 324-8205
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Optometrist (primary) Taxonomy 152W00000X · Licence 5790T (CA)
Corneal and Contact Management Optometrist Taxonomy 152WC0802X · Licence 5790T (CA)

Record details

NPI number1013033059
Entity typeIndividual (Type 1)
GenderMale
Credentials OD
Sole proprietorNo
NPI enumeratedMarch 21, 2007
Last updated in NPPESMay 2, 2014
Mailing address1630 W Redondo Beach Blvd, Suite #1, Gardena, CA 90247-3200

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