# LOUIS LURIE, MD, INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1891859302
- **Authorized official:** LOUIS LURIE MD (PRESIDENT)
- **Authorized official phone:** (619) 426-3240

## Contact information

- **Practice address:** 480 4TH AVE, SUITE 307, CHULA VISTA, CA 91910-4410
- **Practice address phone:** (619) 426-3240
- **Practice address fax:** (619) 426-5964
- **Mailing address:** 480 4TH AVE, SUITE 307, CHULA VISTA, CA 91910-4410
- **Mailing address phone:** (619) 426-3240
- **Mailing address fax:** (619) 426-5964

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207X00000X | Orthopaedic Surgery Physician | G13181 | CA | Yes |

## Other

- **Enumeration date:** 12/20/2006
- **Last updated:** 08/22/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 00G131810 | — | CA |
| 01 | — | G13181 | MEDICAL LICENSE | CA |