| Mark H Bouffard Iv, MD | |
|
72650 Fred Waring Dr, Suite 214, Palm Desert, CA 92260-5006 | |
| (760) 776-7999 | |
| (760) 776-7994 |
| Full Name | Mark H Bouffard Iv |
|---|---|
| Gender | Male |
| Speciality | Physical Medicine And Rehabilitation |
| Experience | 27 Years |
| Location | 72650 Fred Waring Dr, Palm Desert, California |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1528168622 | NPI | - | NPPES |
| P00404516 | Other | CA | MC RAIL ROAD |
| 330808867 | Other | CA | BLUE CROSS GROUP # |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2081P2900X | Physical Medicine & Rehabilitation - Pain Medicine | A89206 (California) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Eisenhower Medical Center | Rancho mirage, CA | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Pain And Spine Center Of The Desert Inc | 4385811009 | 2 |
| Entity Name | Pain And Spine Center Of The Desert Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1285902403 PECOS PAC ID: 4385811009 Enrollment ID: O20120120000752 |
| Mailing Address | Practice Location Address |
|---|---|
| Mark H Bouffard Iv, MD 72650 Fred Waring Dr, Suite 214, Palm Desert, CA 92260-5006 Ph: (760) 776-7999 | Mark H Bouffard Iv, MD 72650 Fred Waring Dr, Suite 214, Palm Desert, CA 92260-5006 Ph: (760) 776-7999 |
Dr. Jay D Roberts, M.D. Physical Medicine & Rehabilitation Medicare: Not Enrolled in Medicare Practice Location: 77920 Country Club Dr, Suite 6-1, Palm Desert, CA 92211 Phone: 760-200-3336 Fax: 760-200-0026 | |
Alexander Kendrall, Physical Medicine & Rehabilitation Medicare: Not Enrolled in Medicare Practice Location: 36953 Cook St Ste 101, Palm Desert, CA 92211 Phone: 760-797-7540 | |
Eric E Carino, OT Physical Medicine & Rehabilitation Medicare: Not Enrolled in Medicare Practice Location: 72670 Fred Waring Dr, Ste 203, Palm Desert, CA 92260 Phone: 760-285-4434 |