| NPI | 1508380031 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEREK B. LAURITZEN President 805-544-0006 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207WX0107X Ophthalmology, Retina Specialist (Licence: CA G77319) |
| Enumeration Date | 2017-07-26 |
| Last Update Date | 2025-03-24 |