Organization
SAN DIEGO SPINE CENTER, AMC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ERIC STEVEN KORSH M.D. (PRESIDENT)
(858) 715-8444
Entity
Organization
Contact information
Practice address
3760 CONVOY ST, 114, SAN DIEGO, CA 92111-3742
(858) 715-8444
(858) 715-8324
Mailing address
3760 CONVOY ST, 114, SAN DIEGO, CA 92111-3742
(858) 715-8444
(858) 715-8324
Taxonomy
Speciality
Code
Description
License number
State
207XS0117X
Orthopaedic Surgery of the Spine Physician
Primary
G84012
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
FX680A
MEDICARE PTAN SAN DIEGO OFFICE
CA
01
—
FX680B
MEDICARE PTAN FOR INDIO OFFICE
CA
Enumeration date
06/01/2007
Last updated
10/16/2020
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