# KEVIN O. LAWRENCE MD INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1659545630
- **Authorized official:** MR. KEVIN ODINNI LAWRENCE MD (OWNER)
- **Authorized official phone:** (909) 581-6400

## Contact information

- **Practice address:** 10841 WHITE OAK AVE, SUITE 201, RANCHO CUCAMONGA, CA 91730-3811
- **Practice address phone:** (909) 581-6400
- **Practice address fax:** (909) 581-7275
- **Mailing address:** 7201 HAVEN AVE, SUITE E298, RANCHO CUCAMONGA, CA 91701-6065
- **Mailing address phone:** (909) 581-6400
- **Mailing address fax:** (909) 581-7275

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208100000X | Physical Medicine & Rehabilitation Physician | A84093 | CA | Yes |

## Other

- **Enumeration date:** 04/21/2008
- **Last updated:** 06/20/2008