Lauritzen, Derek Brian

Lauritzen, Derek Brian is an individual health care provider with primary practice located at 941 California Blvd , San Luis Obispo CA 93401. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Ophthalmology, Allopathic & Osteopathic Physicians / Retina Specialist. Allopathic & Osteopathic Physicians / Retina Specialist is his primary health care specialty. Lauritzen, Derek Brian can be contacted via phone (805) 434-2350.

Contact Information

Primary practice address
941 California Blvd San Luis Obispo CA 93401
Phone: (805) 434-2350
Fax: (805) 434-9888
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Ophthalmology 207W00000X G77319 California
Allopathic & Osteopathic Physicians / Retina Specialist 207WX0107X G77319 California

Profile Details

NPI number 1841348166
LBN Legal business name Lauritzen, Derek Brian
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 5th, 2007
Last updated Jun 22nd, 2018 - about 8 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1841348166 NPPES
California Other 00G773190 BLUE SHIELD OF CALIFORNIA
California MEDICAID 00G773190 BLUE SHIELD OF CALIFORNIA
California Other G77319 BLUE SHIELD OF CALIFORNIA
California Other 7808216 BLUE SHIELD OF CALIFORNIA

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