Individual
JACK JACOB DRUET
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
25495 MEDICAL CENTER DR, SUITE 102, MURRIETA, CA 92562-5963
(951) 506-9536
(951) 693-4631
Mailing address
PO BOX 893520, TEMECULA, CA 92589-3520
(951) 699-0303
(951) 699-0603
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
G70999
CA
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
G70999
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DC4371
RAILROAD MEDICARE GRP #
CA
01
—
P00168751
RAILROAD MEDICARE
CA
Enumeration date
12/01/2005
Last updated
03/07/2023
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