Active NPI
Mark Drucker, M.D.
- General Practice Physician
- Encinitas, CA
National Provider Identifier
1053440024
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Physician
- License
- C42102
- Practice address
- 4403 Manchester Ave
Ste. 107
Encinitas, CA 92024-4939 - Phone
- (760) 632-9042
- Fax
- (760) 632-0574
- NPI assigned
- Mar 5, 2007
- Last updated
- Jul 8, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Physician | 208D00000X | C42102 | CA | Primary |
Addresses
Primary practice location
4403 Manchester Ave
Ste. 107
Encinitas, CA 92024-4939
Mailing address
4403 Manchester Ave
Ste. 107
Encinitas, CA 92024-4939
Phone (760) 632-9042
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160202002237 | CA | Order and Referring Only - General Practice | 9234433871 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 42102 | CA | MD | Endodontist |
| C42102 | CA | MD | General Practice Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1173052800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1053440024",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4403 MANCHESTER AVE",
"address_2": "STE. 107",
"city": "ENCINITAS",
"state": "CA",
"postal_code": "920244939",
"telephone_number": "760-632-9042",
"fax_number": "760-632-0574"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4403 MANCHESTER AVE",
"address_2": "STE. 107",
"city": "ENCINITAS",
"state": "CA",
"postal_code": "920244939",
"telephone_number": "760-632-9042",
"fax_number": "760-632-0574"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DRUCKER",
"first_name": "MARK",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-03-05",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "208D00000X",
"taxonomy_group": "",
"desc": "General Practice",
"state": "CA",
"license": "C42102",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Encinitas, CA
- Dr. Rosa Optometry, Inc.
- Dr. Shawn Kidd Chiropractic Inc. (SK Chiropractic)
- Drew Belnap, MD, a Medical Corporation (South Coast TMS and Ketamine)
- Rebecca Lynn Drexler, OT-C
- Driftwood Family Therapy Collective, Corp.
- Pingfeng Du, M.D.
- Craig Steven Duck, M.D.
- Einat R. Duhamel, M.D.
- Rhonda M Duncan Higgs, LMFT
- Samuel Dungan, DC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.