DR. DEREK BRIAN LAURITZEN (NPI# 1841348166) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1841348166 |
| Entity Type | Individual |
| Full Name | DR. DEREK BRIAN LAURITZEN |
| Credential | M.D. |
| Practice Address |
941 California Blvd San Luis Obispo CA 93401 |
| Mailing Address |
941 California Blvd San Luis Obispo CA 93401-2905 |
| Practice Telephone | 8054342350 |
| Practice Fax Number | 8054349888 |
| Mailing Telephone | 8055440006 |
| Enumeration Date | 2007-01-05 |
| Last Update Date | 2018-06-22 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207W00000X | Ophthalmology | G77319 | CA | Allopathic & Osteopathic Physicians |
| Y | 207WX0107X |
Ophthalmology Specialization: Retina Specialist |
G77319 | CA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | BLUE SHIELD OF CALIFORNIA | 00G773190 | 01 |
| CA | BLUE CROSS | G77319 | 01 |
| CA | AETNA PIN | 7808216 | 01 |
| CA | 00G773190 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1050 Las Tablas Rd Ste 6, Templeton, CA 934659792 | 8054342350 | 8054349888 |
| Street Address |
941 CALIFORNIA BLVD |
| City | SAN LUIS OBISPO |
| State | CA |
| Zip Code | 93401 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255891701 | Central Coast Eye Surgery, Inc., A Professional Medical Corporation | Ophthalmology | 941 California Blvd, San Luis Obispo, CA 93401-2905 | 2019-03-21 |
| 1508380031 | Central Coast Eye Surgery, Inc., A Professional Medical Corporation | Ophthalmology | 941 California Blvd, San Luis Obispo, CA 93401 | 2017-07-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497228399 | Barbara Jean Morrow | Dental Hygienist | 2191 Johnson Avenue, San Luis Obispo, CA 93401 | 2019-01-03 |
| 1104307743 | Griffith Jennings | Counselor | 1225 Kendal Rd, San Luis Obispo, CA 93401 | 2018-08-22 |
| 1124518808 | Joy L Delaluna | Licensed Psychiatric Technician | 692 Evens Rd, San Luis Obispo, CA 93401 | 2018-05-17 |
| 1982192084 | Sierra Mental Wellness Group | Community/Behavioral Health | 2180 B Johnson Avenue, San Luis Obispo, CA 93401 | 2018-04-25 |
| 1326554403 | Veronica Chanel Laguna | Case Manager/Care Coordinator | 1065 Kansas Ave., San Luis Obispo, CA 93401 | 2017-12-27 |
| 1043739782 | Janette Lynn Branca | Case Manager/Care Coordinator | 285 South Street, Suit J, San Louis Obispo, CA 93401 | 2017-09-13 |
| 1588194104 | Adv Vision LLC | Optometrist | 835 Aero Vista Pl, #110, San Luis Obispo, CA 93401 | 2017-06-15 |
| 1508395880 | Samantha Clay | Counselor | 1255 Kendall Road, San Luis Obispo, CA 93401 | 2017-06-08 |
| 1659804771 | Sara Anne Powers | Counselor | 697 Higuera Street D, San Luis Obispo, CA 93401 | 2017-04-05 |
| 1508306010 | Russell Piazza | Pharmacist | 873 Ricardo Court, San Luis Obispo, CA 93401 | 2017-03-02 |
| Find all providers in zip 93401 | ||||
| Taxonomy Code | 207WX0107X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Ophthalmology |
| Specialization | Retina Specialist |
| An ophthalmologist who specializes in the diagnosis and treatment of vitreoretinal diseases. |
| Notes: Source: American Society of Retina Specialists, www.asrs.org [1/1/2017: new] - Additional Resources: American Academy of Ophthalmology, www.aao.org. Macula Society, www.maculasociety.org. Retina Society, www.retinasociety.org. Association of University Professors of Ophthalmology, www.aupo.org. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992228795 | Central Coast Eye, Inc., A Professional Medical Corporation | Ophthalmology | 628 California Blvd Ste C, San Luis Obispo, CA 93401-2547 | 2017-07-24 |
| 1255891701 | Central Coast Eye Surgery, Inc., A Professional Medical Corporation | Ophthalmology | 941 California Blvd, San Luis Obispo, CA 93401-2905 | 2019-03-21 |
| 1508380031 | Central Coast Eye Surgery, Inc., A Professional Medical Corporation | Ophthalmology | 941 California Blvd, San Luis Obispo, CA 93401 | 2017-07-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760031363 | Salehi Retina Institute Inc. | Ophthalmology | 7777 Edinger Ave Ste 234, Huntington Beach, CA 92647-8693 | 2019-09-06 |
| 1669969960 | Vitreo-retinal Medical Group, Inc | Ophthalmology | 1680 E Roseville Pkwy Ste 140, Roseville, CA 95661-3988 | 2018-04-23 |
| 1144733403 | Vitreo-retinal Medical Group Inc | Ophthalmology | 1870 Lassen Blvd Ste B, Yuba City, CA 95993-9455 | 2017-11-08 |
| 1831608264 | Robert Kim | Ophthalmology | 95 Kirkham Avenue, 201, Box 0730, San Francisco, CA 94122 | 2017-09-28 |
| 1538687785 | Thomas Carl Salzano | Ophthalmology | 204 Gainsborough Circle, Folsom, CA 95630 | 2017-09-07 |
| 1295013712 | Mukesh Bhogilal Suthar Md Inc | Ophthalmology | 10808 Foothill Blvd Ste 160-203, Rancho Cucamonga, CA 91730-3889 | 2011-08-01 |
| 1790928067 | Bay Area Retina Associates,medical Group | Ophthalmology | 1460 N Camino Alto Ste 109, Vallejo, CA 94589-2567 | 2009-04-15 |
| 1083857353 | Bay Area Retina Associates,medical Group | Ophthalmology | 15051 Hesperian Blvd Ste D, San Leandro, CA 94578-3536 | 2009-04-15 |
| 1942489356 | Ash Pirouz | Ophthalmology | 301 W Bastanchury Rd Ste 285, Fullerton, CA 92835-3432 | 2007-11-01 |
| 1710170253 | Maziar Lalezary | Ophthalmology | 8383 Wilshire Blvd Ste 440, Beverly Hills, CA 90211-2436 | 2007-08-18 |
| Find all providers with the same taxonomy | ||||
| City | SAN LUIS OBISPO |
| Zip Code | 93401 |
Please comment or provide details below to improve the information on DR. DEREK BRIAN LAURITZEN.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.