Provider Demographics
NPI:1043228182
Name:CORISH, ARTHUR BRIAN (OD)
Entity Type:Individual
Prefix:DR
First Name:ARTHUR
Middle Name:BRIAN
Last Name:CORISH
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
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Mailing Address - Street 1:15785 LAGUNA CANYON RD
Mailing Address - Street 2:SUITE 260
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92618-3165
Mailing Address - Country:US
Mailing Address - Phone:949-559-5905
Mailing Address - Fax:949-552-4916
Practice Address - Street 1:15785 LAGUNA CANYON RD
Practice Address - Street 2:SUITE 260
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92618-3165
Practice Address - Country:US
Practice Address - Phone:949-559-5905
Practice Address - Fax:949-552-4916
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-04
Last Update Date:2015-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA6191T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAT70096Medicare UPIN
CAOP6191Medicare ID - Type Unspecified