# JACK J DRUET, MD, INC.

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

## Provider details

- **NPI number:** 1114114881
- **Authorized official:** DR. JACK J DRUET M.D. (MEDICAL DIRECTOR)
- **Authorized official phone:** (951) 506-9536

## Contact information

- **Practice address:** 25495 MEDICAL CENTER DR, SUITE 102, MURRIETA, CA 92562-5963
- **Practice address phone:** (951) 506-9536
- **Practice address fax:** (951) 693-4631
- **Mailing address:** 43500 RIDGE PARK DR, SUITE 102, TEMECULA, CA 92590-3624
- **Mailing address phone:** (951) 699-0303
- **Mailing address fax:** (951) 699-1145

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207L00000X | Anesthesiology Physician | G70999 | CA | — |
| 207LP2900X | Pain Medicine (Anesthesiology) Physician | G70999 | CA | Yes |

## Other

- **Enumeration date:** 09/26/2007
- **Last updated:** 03/07/2023