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Organization
RETINA SPECIALISTS OF THE CENTRAL COAST INC
Active
Organization
RETINA SPECIALISTS OF THE CENTRAL COAST INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DEREK B. LAURITZEN M.D. (PRESIDENT)
(805) 547-2090
Entity
Organization
Contact information
Practice address
628 CALIFORNIA BLVD, SUITE C, SAN LUIS OBISPO, CA 93401-2542
(805) 547-2090
(805) 547-2095
Mailing address
628 CALIFORNIA BLVD, SUITE C, SAN LUIS OBISPO, CA 93401-2542
(805) 547-2090
(805) 547-2095
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
C3049777
CA
Other
Enumeration date
12/07/2007
Last updated
11/18/2009
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