Organization
COURIQUE OPTICAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL T COURIS M.D. (OWNER)
(619) 291-6191
Entity
Organization
Contact information
Practice address
3969 4TH AVE, SUITE 301, SAN DIEGO, CA 92103-3165
(619) 298-4200
(619) 291-0049
Mailing address
3969 4TH AVE, SUITE 301, SAN DIEGO, CA 92103-3165
(619) 298-4200
(619) 291-0049
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
4401850001
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A532650
—
CA
Enumeration date
07/05/2006
Last updated
03/09/2010
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