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General NPI Number Information
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NPI Number | 1811969991
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Entity Type | Individual
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Provider Name | ALAN BRUCE DOUGLASS M.D.
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Gender | Male
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Dates
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Enumeration Date | 02/03/2006
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Last Update Date | 05/09/2025
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Provider Practice Location Address
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Address Line | 34800 BOB WILSON DR
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City | SAN DIEGO
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State | CA
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Zip | 92134-1098
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Country | US
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Telephone | 619-532-7375
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Fax | 619-532-5472
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Provider Business Mailing Address
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Address Line | 625 W. CITRACADO PARKWAY SUITE 108
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City | ESCONDIDO
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State | CA
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Zip | 92025
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Country | US
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Telephone | 760-743-1431
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Fax | 760-743-6455
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RE0101X
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Taxonomy Name | Endocrinology, Diabetes & Metabolism Physician
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License Number | G75547
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License Number State | CA
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