Provider Demographics
NPI:1871594168
Name:CRONIN, LAWRENCE R (MD)
Entity type:Individual
Prefix:DR
First Name:LAWRENCE
Middle Name:R
Last Name:CRONIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:PO BOX 1279
Mailing Address - Street 2:
Mailing Address - City:SANTA CRUZ
Mailing Address - State:CA
Mailing Address - Zip Code:95061-1279
Mailing Address - Country:US
Mailing Address - Phone:520-975-8520
Mailing Address - Fax:831-603-6478
Practice Address - Street 1:6265 HIGHWAY 9
Practice Address - Street 2:
Practice Address - City:FELTON
Practice Address - State:CA
Practice Address - Zip Code:95018-9710
Practice Address - Country:US
Practice Address - Phone:831-461-4993
Practice Address - Fax:831-603-6478
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-09
Last Update Date:2020-12-09
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAG543862084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
E07011Medicare UPIN
AZ71023Medicare ID - Type Unspecified