Provider Demographics
NPI:1124230008
Name:KRONISCH, ROBERT LAURENCE (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:LAURENCE
Last Name:KRONISCH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:SAN JOSE STATE UNIVERSITY STUDENT HEALTH CTR
Mailing Address - Street 2:ONE WASHINGTON SQUARE
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95192-0037
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:SAN JOSE STATE UNIVERSITY STUDENT HEALTH CTR
Practice Address - Street 2:ONE WASHINGTON SQUARE
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95192-0037
Practice Address - Country:US
Practice Address - Phone:408-924-6120
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG63975207QS0010X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QS0010XAllopathic & Osteopathic PhysiciansFamily MedicineSports Medicine