CENTRAL COAST EYE SURGERY, INC., A PROFESSIONAL MEDICAL CORPORATION – NPI #1508380031
Ophthalmology

An ophthalmologist who specializes in the diagnosis and treatment of vitreoretinal diseases.

Health Care Provider Taxonomy Code for Ophthalmology

CENTRAL COAST EYE SURGERY, INC., A PROFESSIONAL MEDICAL CORPORATION is an ophthalmologist located in SAN LUIS OBISPO, CA. NPPES has assigned the NPI number 1508380031 to CENTRAL COAST EYE SURGERY, INC., A PROFESSIONAL MEDICAL CORPORATION on July 26, 2017. It is a Type-2 NPI, indicating this NPI number is associated with an organization. The primary taxonomy selected by this provider is 207WX0107X from the Health Care Provider Taxonomy code set, which is classified as Ophthalmology, specializing in Retina Specialist

The NPI profile was last updated on Mar 24, 2025. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for CENTRAL COAST EYE SURGERY, INC., A PROFESSIONAL MEDICAL CORPORATION below.

NPI Profile for
CENTRAL COAST EYE SURGERY, INC., A PROFESSIONAL MEDICAL CORPORATION

NPI Number
1508380031
Enumeration Date

(about 9 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
CENTRAL COAST EYE SURGERY, INC., A PROFESSIONAL MEDICAL CORPORATION
Primary location
941 CALIFORNIA BLVD
SAN LUIS OBISPO, CA 93401
Phone: (805) 544-0006 Fax: (877) 843-9745
1 Other location(s):
1050 Las Tablas Rd Ste 6
Templeton, CA 93465-9792
Phone: (805) 544-0006
Fax: (877) 843-9745
Mailing address
Same as primary location
Organization Subpart
No
Authorized Official
DEREK LAURITZEN
PRESIDENT
Phone: (805) 544-0006
Updated
Certification Date
Mar 24, 2025

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
207WX0107X
- Ophthalmology / Retina Specialist (Primary)		 CA G77319

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.