Healthcare Provider Details

I. General information

NPI: 1912199704
Provider Name (Legal Business Name): PAUL C DRURY M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/15/2007
Last Update Date: 08/24/2026
Certification Date: 08/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

24012 CALLE DE LA PLATA STE 450
LAGUNA HILLS CA
92653-7625
US

IV. Provider business mailing address

24012 CALLE DE LA PLATA STE 450
LAGUNA HILLS CA
92653-7625
US

V. Phone/Fax

Practice location:
  • Phone: 949-770-6252
  • Fax: 949-770-1124
Mailing address:
  • Phone: 949-770-6252
  • Fax: 949-770-1124

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0001X
TaxonomyClinical Cardiac Electrophysiology Physician
License NumberA106009
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberA106009
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: