MEDICARE: DR. LAWRENCE R CRONIN MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084P0800X	Psychiatry Physician	G54386	CA

General Provider Information

NPI Number	:	1871594168
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LAWRENCE R CRONIN MD

Provider Business Mailing Address
First Line	:	PO BOX 1279
Second Line	:
City	:	SANTA CRUZ
State	:	CA
Zip	:	95061-1279
Country	:	US
Telephone Number	:	520-975-8520
Fax Number	:	831-603-6478

Provider Business Practice Location Address
First Line	:	6265 HIGHWAY 9
Second Line	:
City	:	FELTON
State	:	CA
Zip	:	95018-9710
Country	:	US
Telephone Number	:	831-461-4993
Fax Number	:	831-603-6478

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/09/2005
Last Update Date	:	12/09/2020

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