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Organization
RENEE LAURITZEN MD A PROFESSIONAL CORPORATION
Active
Organization
RENEE LAURITZEN MD A PROFESSIONAL CORPORATION
Active
Other names
Pacific Orthopedics and Sports Medicine
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. RENEE S LAURITZEN M.D. (DOCTOR)
(805) 542-9678
Entity
Organization
Contact information
Practice address
1500 PALM ST, SUITE A, SAN LUIS OBISPO, CA 93401-2998
(805) 542-9678
(805) 542-9685
Mailing address
1500 PALM ST, SUITE A, SAN LUIS OBISPO, CA 93401-2998
(805) 542-9678
(805) 542-9685
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
G77320
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00G773200
BLUE SHIELD
CA
01
—
G77320
BLUE CROSS
CA
Enumeration date
11/13/2006
Last updated
08/28/2009
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