Organization
CENTRAL COAST EYE SURGERY, INC., A PROFESSIONAL MEDICAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DEREK B. LAURITZEN M.D. (PRESIDENT)
(805) 544-0006
Entity
Organization
Contact information
Practice address
941 CALIFORNIA BLVD, SAN LUIS OBISPO, CA 93401
(805) 544-0006
(877) 843-9745
Mailing address
941 CALIFORNIA BLVD, SAN LUIS OBISPO, CA 93401-2905
(805) 544-0006
Taxonomy
Speciality
Code
Description
License number
State
207WX0107X
Retina Specialist (Ophthalmology) Physician
Primary
G77319
CA
Other
Enumeration date
07/26/2017
Last updated
03/24/2025
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