Provider Demographics
NPI:1992760169
Name:KORSH, ERIC STEVEN (MD)
Entity type:Individual
Prefix:DR
First Name:ERIC
Middle Name:STEVEN
Last Name:KORSH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:3760 CONVOY ST
Mailing Address - Street 2:SUITE 114
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92111-3742
Mailing Address - Country:US
Mailing Address - Phone:858-715-8444
Mailing Address - Fax:858-715-8324
Practice Address - Street 1:3760 CONVOY ST
Practice Address - Street 2:SUITE 114
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92111-3742
Practice Address - Country:US
Practice Address - Phone:858-715-8444
Practice Address - Fax:858-715-8324
Is Sole Proprietor?:No
Enumeration Date:2006-04-19
Last Update Date:2020-10-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAG84012207XS0117X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0117XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Surgery of the Spine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAFX680XOtherMEDICARE PTAN FOR INDIO OFFICE
CAFX680ZOtherMEDICARE PTAN FX680Z FOR SAN DIEGO OFFICE