Provider Demographics
NPI:1679605380
Name:LAWRENCE A CONE MD A PROFESSIONAL CORPORATION
Entity type:Organization
Organization Name:LAWRENCE A CONE MD A PROFESSIONAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LAWRENCE
Authorized Official - Middle Name:A
Authorized Official - Last Name:CONE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:760-346-5688
Mailing Address - Street 1:39000 BOB HOPE DR
Mailing Address - Street 2:PROBST 308
Mailing Address - City:RANCHO MIRAGE
Mailing Address - State:CA
Mailing Address - Zip Code:92270-3221
Mailing Address - Country:US
Mailing Address - Phone:760-346-5688
Mailing Address - Fax:760-773-3976
Practice Address - Street 1:39000 BOB HOPE DR
Practice Address - Street 2:PROBST 308
Practice Address - City:RANCHO MIRAGE
Practice Address - State:CA
Practice Address - Zip Code:92270-3221
Practice Address - Country:US
Practice Address - Phone:760-346-5688
Practice Address - Fax:760-773-3976
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious DiseaseGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA8576416Medicaid
CAA245920Medicare UPIN
CA8576416Medicaid