Provider Demographics
NPI:1063464675
Name:KONING, LAWRENCE (MD)
Entity type:Individual
Prefix:DR
First Name:LAWRENCE
Middle Name:
Last Name:KONING
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 720130
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92172-0130
Mailing Address - Country:US
Mailing Address - Phone:951-317-6098
Mailing Address - Fax:
Practice Address - Street 1:13143 GREER DR
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92129-3399
Practice Address - Country:US
Practice Address - Phone:951-317-6098
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-16
Last Update Date:2025-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG48583207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G485830Medicaid
CAA51105Medicare UPIN