Provider Demographics
NPI:1801314042
Name:COURIS, ERIKA DIMITRA (PA-C)
Entity type:Individual
Prefix:
First Name:ERIKA
Middle Name:DIMITRA
Last Name:COURIS
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3260 3RD AVE
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92103-5616
Mailing Address - Country:US
Mailing Address - Phone:619-865-4867
Mailing Address - Fax:619-291-0049
Practice Address - Street 1:3969 FOURTH AVE
Practice Address - Street 2:#301
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92103-9210
Practice Address - Country:US
Practice Address - Phone:619-291-6191
Practice Address - Fax:619-291-6191
Is Sole Proprietor?:No
Enumeration Date:2017-09-08
Last Update Date:2018-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA13978363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical