Provider Demographics
NPI:1508026709
Name:ARTHUR B. CORISH, O.D., INC.
Entity Type:Organization
Organization Name:ARTHUR B. CORISH, O.D., INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ARTHUR
Authorized Official - Middle Name:B
Authorized Official - Last Name:CORISH
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:949-559-5905
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
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-11
Last Update Date:2013-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA6191T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADR3008OtherPTAN
CADO209AMedicare PIN
CADR3008Medicare PIN