Basic Information
| Provider Information | |||||||||
| NPI: | 1295725281 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | DRUCKER | ||||||||
| FirstName: | ALAN | ||||||||
| MiddleName: | J | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 400 S FARRELL DR | ||||||||
| Address2: | STE B160 | ||||||||
| City: | PALM SPRINGS | ||||||||
| State: | CA | ||||||||
| PostalCode: | 922627954 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7603223705 | ||||||||
| FaxNumber: | 8883926660 | ||||||||
| Practice Location | |||||||||
| Address1: | 400 S FARRELL DR STE B160 | ||||||||
| Address2: | |||||||||
| City: | PALM SPRINGS | ||||||||
| State: | CA | ||||||||
| PostalCode: | 922627954 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7603223705 | ||||||||
| FaxNumber: | 8883926660 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/21/2005 | ||||||||
| LastUpdateDate: | 02/06/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 02/06/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2084P0800X | G067228 | CA | Y | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Psychiatry |
ID Information
| ID | Type | State | Issuer | Description | 260018554 | 01 | MEDICARE RAILROAD | OTHER | 00G672280 | 01 | CA | BLUE CROSS | OTHER | 00G672280 | 05 | CA | MEDICAID | 00G672280 | 01 | CA | BLUE SHIELD | OTHER |