Provider Demographics
NPI:1063464675
Name:KONING, LAWRENCE (MD)
Entity Type:Individual
Prefix:DR
First Name:LAWRENCE
Middle Name:
Last Name:KONING
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:341 MAGNOLIA AVE
Mailing Address - Street 2:SUITE 202
Mailing Address - City:CORONA
Mailing Address - State:CA
Mailing Address - Zip Code:92879-3300
Mailing Address - Country:US
Mailing Address - Phone:951-371-0844
Mailing Address - Fax:951-371-4022
Practice Address - Street 1:341 MAGNOLIA AVE
Practice Address - Street 2:SUITE 202
Practice Address - City:CORONA
Practice Address - State:CA
Practice Address - Zip Code:92879-3300
Practice Address - Country:US
Practice Address - Phone:951-371-0844
Practice Address - Fax:951-371-4022
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-16
Last Update Date:2017-08-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAG48583207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G485830Medicaid
CAA51105Medicare UPIN