MARK H BOUFFARD IV (NPI# 1528168622) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1528168622 |
| Entity Type | Individual |
| Full Name | MARK H BOUFFARD IV |
| Credential | M.D. |
| Practice Address |
72650 Fred Waring Dr Suite 214 Palm Desert CA 92260-5006 |
| Practice Telephone | 7607767999 |
| Practice Fax Number | 7607767994 |
| Mailing Telephone | 7607767999 |
| Mailing Fax Number | 7607767994 |
| Enumeration Date | 2006-09-25 |
| Last Update Date | 2019-08-12 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2081P2900X |
Physical Medicine & Rehabilitation Specialization: Pain Medicine |
A89206 | CA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | BLUE CROSS GROUP # | 330808867 | 01 |
| CA | MC RAIL ROAD | P00404516 | 01 |
| Street Address |
72650 FRED WARING DR SUITE 214 |
| City | PALM DESERT |
| State | CA |
| Zip Code | 92260-5006 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821027228 | David T Bowen | Orthopaedic Surgery | 72650 Fred Waring Dr, Suite 109, Palm Desert, CA 92260-5006 | 2006-06-30 |
| 1316400757 | Ramy Mena | Radiologic Technologist | 72650 Fred Waring Dr, Palm Desert, CA 92260-5006 | 2019-04-11 |
| 1174949945 | Desert Hand and Plastic Surgery PC | Orthopaedic Surgery | 72650 Fred Waring Dr, Suite 109, Palm Desert, CA 92260-5006 | 2014-03-17 |
| 1023387388 | Desert Neuroscience Institute | Anesthesiology | 72650 Fred Waring Dr, Suite 106, Palm Desert, CA 92260-5006 | 2011-12-15 |
| 1124340922 | Eola Anne Bentley-force | Nurse Practitioner | 72650 Fred Waring Dr, Suite 214, Palm Desert, CA 92260-5006 | 2010-02-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003414202 | Arianna D Aguilar | Behavioral Analyst | 7410 Highway 111 Suite 102, Palm Desert, CA 92260 | 2020-10-12 |
| 1063053098 | Sylvia Ann Trapuzzano | Marriage & Family Therapist | 74-040 Highway IIi, Suite L-202, Palm Desert, CA 92260 | 2019-10-01 |
| 1477011153 | Alexis Ivonne Corrales | Behavior Technician | 74-710 Ca-111, Ste #102, Palm Desert, CA 92260 | 2019-03-12 |
| 1992272421 | Sarah Baik | Pharmacist | 72314 Ca-111, Palm Desert, CA 92260 | 2018-11-02 |
| 1104329820 | Oz Med, Inc. | Pharmacy | 44150 Town Center Way, Ste B4, Palm Desert, CA 92260 | 2018-03-09 |
| 1598272577 | Eisenhower Medical Center | General Acute Care Hospital | 74020 Alessandro Drive, Suite B, Palm Desert, CA 92260 | 2017-12-29 |
| 1225540180 | Dr Fatemeh Hadjian D.d.s. P.a. | Dentist | 74000 Country Club Ste B1, Palm Desert, CA 92260 | 2017-11-01 |
| 1871032185 | Brianne Lee Stoddard | Behavioral Analyst | 41555 Cook Street, Suite 100, Palm Desert, CA 92260 | 2017-02-20 |
| 1275072720 | Michael Giordano Jerez | Chiropractor | 72840 Ca - 111 Suite 2, Palm Desert, CA 92260 | 2017-02-16 |
| 1982150785 | Joshua W Cartter Dds Inc | Dentist | 72415 Park View, Palm Desert, CA 92260 | 2016-08-31 |
| Find all providers in zip 92260 | ||||
| Taxonomy Code | 2081P2900X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Physical Medicine & Rehabilitation |
| Specialization | Pain Medicine |
| A physician who provides a high level of care, either as a primary physician or consultant, for patients experiencing problems with acute, chronic or cancer pain in both hospital and ambulatory settings. Patient care needs may also be coordinated with other specialists. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition changed, source changed] Additional Resources: American Board of Physical Medicine and Rehabilitation, 2007. http://www.abpmr.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Physical Medicine and Rehabilitation. A subspecialty certificate was approved by the ABMS in 1999. ACGME Accredited Residency Program Requirements: Proposal under development. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104263607 | Eric Yuan | Physical Medicine & Rehabilitation | 75036 Gerald Ford Dr, Palm Desert, CA 92211-2080 | 2013-05-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881295608 | San Diego Comprehensive Pain Management Center, Inc | Physical Medicine & Rehabilitation | 1575 W Main St, El Centro, CA 92243-2211 | 2020-11-06 |
| 1760013536 | Aveva Medical Aesthetics Inc. | Physical Medicine & Rehabilitation | 4702 W 1st St Ste C, Santa Ana, CA 92703-3100 | 2020-01-30 |
| 1902445620 | Irina L Melnik, Md Professional Corporation | Physical Medicine & Rehabilitation | 655 Redwood Hwy Frontage Rd Ste 203, Mill Valley, CA 94941-3025 | 2019-12-27 |
| 1124669544 | Algos Inc., A Medical Corporation | Physical Medicine & Rehabilitation | 26357 Mcbean Pkwy Ste 210, Santa Clarita, CA 91355-4497 | 2019-10-07 |
| 1174084578 | Lags Spine and Sportscare Medical Centers, Inc. | Physical Medicine & Rehabilitation | 802 Iowa Ave, Los Banos, CA 93635-3450 | 2019-03-28 |
| 1083175483 | Lags Spine and Sportscare Medical Centers, Inc. | Physical Medicine & Rehabilitation | 777 S Ham Ln Ste G, Lodi, CA 95242-3593 | 2019-03-28 |
| 1679031611 | Jesus H. Lao Md Inc | Physical Medicine & Rehabilitation | 6699 Alvarado Rd Ste 2304, San Diego, CA 92120-5241 | 2019-03-08 |
| 1316404262 | Advanced Pain Diagnostic & Solutions, Inc. | Physical Medicine & Rehabilitation | 1921 Sycamore Ln, Davis, CA 95616-0844 | 2019-02-27 |
| 1689157059 | Lags Spine and Sportscare Medical Centers, Inc. | Physical Medicine & Rehabilitation | 801 E Chapel St Ste 6, Santa Maria, CA 93454-4607 | 2018-09-12 |
| 1588147094 | Lags Spine and Sportscare Medical Centers, Inc. | Physical Medicine & Rehabilitation | 803 Coffee Rd Ste 11, Modesto, CA 95355-4244 | 2018-09-11 |
| Find all providers with the same taxonomy | ||||
| City | PALM DESERT |
| Zip Code | 92260 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.