Healthcare Provider Details

I. General information

NPI: 1265345318
Provider Name (Legal Business Name): STORK INDUSTRIES, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/28/2026
Last Update Date: 09/28/2026
Certification Date: 09/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1300 N VERMONT AVE
LOS ANGELES CA
90027-6005
US

IV. Provider business mailing address

2629 MANHATTAN AVE # 283
HERMOSA BEACH CA
90254-2411
US

V. Phone/Fax

Practice location:
  • Phone: 310-629-2447
  • Fax: 310-306-5555
Mailing address:
  • Phone: 310-629-2447
  • Fax: 310-306-5555

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number
License Number StateNULL

VIII. Authorized Official

Name: DR. JAMIE ALAN LIPELES
Title or Position: DO
Credential:
Phone: 310-629-2447