Provider Demographics
NPI:1336658715
Name:LAWRENCE KONING, MD, INC
Entity Type:Organization
Organization Name:LAWRENCE KONING, MD, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LAWRENCE
Authorized Official - Middle Name:
Authorized Official - Last Name:KONING
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:951-371-0844
Mailing Address - Street 1:341 MAGNOLIA AVE STE 202
Mailing Address - Street 2:
Mailing Address - City:CORONA
Mailing Address - State:CA
Mailing Address - Zip Code:92879-3332
Mailing Address - Country:US
Mailing Address - Phone:951-371-0844
Mailing Address - Fax:951-371-4022
Practice Address - Street 1:341 MAGNOLIA AVE STE 202
Practice Address - Street 2:
Practice Address - City:CORONA
Practice Address - State:CA
Practice Address - Zip Code:92879-3332
Practice Address - Country:US
Practice Address - Phone:951-371-0844
Practice Address - Fax:951-371-4022
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-09-28
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG48583207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty