Organization Active NPI

Kevin O. Lawrence MD Inc

  • Physical Medicine & Rehabilitation Physician
  • Rancho Cucamonga, CA
National Provider Identifier
1659545630
Registry record updated Jun 20, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
A84093 Issued in CA
Legal business name
KEVIN O. LAWRENCE MD INC
Practice address
10841 White Oak Ave
Suite 201
Rancho Cucamonga, CA 91730-3811
Phone
(909) 581-6400
Fax
(909) 581-7275
NPI assigned
Apr 21, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 20, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. Kevin Odinni Lawrence, MDNPI 1215913058
Title
Owner
Phone
(909) 581-6400

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208100000X A84093 CA Primary

Addresses

Primary practice location

10841 White Oak Ave
Suite 201
Rancho Cucamonga, CA 91730-3811

Mailing address

7201 Haven Ave
Suite E298
Rancho Cucamonga, CA 91701-6065
Phone (909) 581-6400

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20081027000762 CA Part B Supplier - Clinic/Group Practice 1658439179 Receives reassigned benefits from 1 practitioner
Practice locations: Pasadena, CA; Victorville, CA; Upland, CA; San Gabriel, CA; San Bernardino, CA; Rancho Cucamonga, CA; Pomona, CA; Perris, CA…

National Provider Directory

National Provider Directory

Locations

349 E Main St
Alhambra, CA 91801
Phone (626) 282-3151

4300 Green River Rd
Ste 114
Corona, CA 92878
Phone (951) 382-4238

82262 Valencia Ave
Indio, CA 92201
Phone (760) 347-6000

6071 York Blvd
Los Angeles, CA 90042
Phone (323) 254-3407

7201 Haven Ave
Ste E298
Rancho Cucamonga, CA 91701

10808 Foothill Blvd
Ste 160338
Rch Cucamonga, CA 91730
Phone (909) 749-6469

10841 White Oak Ave
#201
Rch Cucamonga, CA 91730
Phone (909) 481-2378

Practitioners & affiliated clinicians

Practitioners 12

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1208736000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213920000000",
    "number": "1659545630",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7201 HAVEN AVE",
            "address_2": "SUITE E298",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917016065",
            "telephone_number": "909-581-6400",
            "fax_number": "909-581-7275"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10841 WHITE OAK AVE",
            "address_2": "SUITE 201",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917303811",
            "telephone_number": "909-581-6400",
            "fax_number": "909-581-7275"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KEVIN O. LAWRENCE MD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-21",
        "last_updated": "2008-06-20",
        "status": "A",
        "authorized_official_last_name": "LAWRENCE",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_middle_name": "ODINNI",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "909-581-6400",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "CA",
            "license": "A84093",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rancho Cucamonga, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.