Provider Demographics
NPI:1730412024
Name:GENE C. LAWRENCE, M.D., INC.
Entity type:Organization
Organization Name:GENE C. LAWRENCE, M.D., INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:GENE
Authorized Official - Middle Name:CURTISS
Authorized Official - Last Name:LAWRENCE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:949-244-7988
Mailing Address - Street 1:220 NEWPORT CENTER DR
Mailing Address - Street 2:#11-286
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92660-7506
Mailing Address - Country:US
Mailing Address - Phone:949-244-7988
Mailing Address - Fax:949-644-8786
Practice Address - Street 1:220 NEWPORT CENTER DR
Practice Address - Street 2:#11-286
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92660-7506
Practice Address - Country:US
Practice Address - Phone:949-244-7988
Practice Address - Fax:949-644-8786
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-17
Last Update Date:2009-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA87320Medicare UPIN