Doctor Name: | MARK DRUCKER |
NPI Number: | 1053440024 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.D. |
License Number: | C42102 |
Business Practice Address: | 4403 Manchester Ave Ste. 107 Encinitas, CA - 920244939 |
Business Phone Number: | 7606329042 |
Business Fax Number: | 7606320574 |
Mailing Address: | 4403 Manchester Ave, Ste. 107 ENCINITAS |
State: | CA |
Postal Code: | 920244939 |
Phone Number: | 7606329042 |
Fax Number: | 7606320574 |
NPI Enumeration Date: | 03/05/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | C42102 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |