Provider Demographics
NPI:1467593327
Name:PAUL D. CORONA, M.D., INC.
Entity Type:Organization
Organization Name:PAUL D. CORONA, M.D., INC.
Other - Org Name:SOUTH COUNTY FAMILY MEDICAL GROUP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:D
Authorized Official - Last Name:CORONA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:949-349-1930
Mailing Address - Street 1:30251 GOLDEN LANTERN
Mailing Address - Street 2:SUITE E 523
Mailing Address - City:LAGUNA NIGUEL
Mailing Address - State:CA
Mailing Address - Zip Code:92677-5993
Mailing Address - Country:US
Mailing Address - Phone:949-481-0118
Mailing Address - Fax:949-481-1162
Practice Address - Street 1:27020 ALICIA PKWY
Practice Address - Street 2:SUITE G
Practice Address - City:LAGUNA NIGUEL
Practice Address - State:CA
Practice Address - Zip Code:92677-3420
Practice Address - Country:US
Practice Address - Phone:949-349-1930
Practice Address - Fax:949-349-1940
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-12
Last Update Date:2008-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAW14428Medicare ID - Type Unspecified