Provider Demographics
NPI:1912199704
Name:DRURY, PAUL C (MD)
Entity Type:Individual
Prefix:
First Name:PAUL
Middle Name:C
Last Name:DRURY
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Gender:M
Credentials:MD
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Mailing Address - Street 1:3080 BRISTOL ST
Mailing Address - Street 2:SUITE 600
Mailing Address - City:COSTA MESA
Mailing Address - State:CA
Mailing Address - Zip Code:92626-3093
Mailing Address - Country:US
Mailing Address - Phone:714-445-0228
Mailing Address - Fax:714-445-0246
Practice Address - Street 1:24022 CALLE DE LA PLATA
Practice Address - Street 2:SUITE 500
Practice Address - City:LAGUNA HILLS
Practice Address - State:CA
Practice Address - Zip Code:92653-3626
Practice Address - Country:US
Practice Address - Phone:714-445-0220
Practice Address - Fax:714-445-0246
Is Sole Proprietor?:No
Enumeration Date:2007-08-15
Last Update Date:2021-06-08
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Provider Licenses
StateLicense IDTaxonomies
CAA106009207RC0000X, 207RI0011X, 207RC0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0001XAllopathic & Osteopathic PhysiciansInternal MedicineClinical Cardiac Electrophysiology
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CB217269Medicare Oscar/Certification