Healthcare Provider Details

I. General information

NPI: 1326031980
Provider Name (Legal Business Name): ALAN BRUCE HURSCHMAN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/29/2005
Last Update Date: 03/11/2019
Certification Date:
Deactivation Date: 03/23/2006
Reactivation Date: 03/27/2006

III. Provider practice location address

5395 RUFFIN RD STE 204
SAN DIEGO CA
92123-1338
US

IV. Provider business mailing address

521 S SIERRA AVE UNIT 168
SOLANA BEACH CA
92075-2246
US

V. Phone/Fax

Practice location:
  • Phone: 858-571-3630
  • Fax: 858-430-3146
Mailing address:
  • Phone: 817-793-6097
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2081P2900X
TaxonomyPain Medicine (Physical Medicine & Rehabilitation) Physician
License NumberH7682
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code2081P2900X
TaxonomyPain Medicine (Physical Medicine & Rehabilitation) Physician
License NumberC155336
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: