Pain and Spine Center of the Desert Inc.

Primary specialty

Pain Clinic/CenterTaxonomy code 261QP3300X

Legal business name

PAIN AND SPINE CENTER OF THE DESERT INC.

Practice address

73271 Fred Waring Dr
Suite 102
Palm Desert, CA 92260-2883

Phone

(760) 776-7999

Fax

(760) 776-7994

NPI assigned

Dec 2, 2011

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Mark Henry Coronel Bouffard IV, M.D.NPI 1528168622

Title

President

Phone

(760) 776-7999

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Mark H Bouffard IV, M.D.

  • Pain Medicine (Physical Medicine & Rehabilitation) Physician
  • Palm Desert, CA
  • NPI 1528168622
  Medicare reassignment Care Compare group NPD Authorized official
• Eola Anne Bentley-Force, FNP

  • Family Nurse Practitioner
  • Palm Desert, CA
  • NPI 1124340922
  Medicare reassignment Care Compare group NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1322784000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1404864000000",
    "number": "1285902403",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6720",
            "city": "LA QUINTA",
            "state": "CA",
            "postal_code": "922486720",
            "telephone_number": "760-776-7999",
            "fax_number": "760-776-7994"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "73271 FRED WARING DR",
            "address_2": "SUITE 102",
            "city": "PALM DESERT",
            "state": "CA",
            "postal_code": "922602883",
            "telephone_number": "760-776-7999",
            "fax_number": "760-776-7994"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAIN AND SPINE CENTER OF THE DESERT INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-12-02",
        "last_updated": "2014-07-09",
        "status": "A",
        "authorized_official_last_name": "BOUFFARD",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "HENRY CORONEL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "760-776-7999",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "IV",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QP3300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Pain",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Serkan Ozturk, RPH
• Luis Pacheco, M.D.
• Pacifica Recovery Inc
• Pacifica Recovery, Inc.
• Sarai Padilla-Torres
• Sergio Steven Palafox, OD
• Palm Desert Community Healthcare, LLC (Desert Springs Post Acute)
• Palm Desert Pediatrics Inc
• Palm Desert Pharmacy Inc (Palm Desert Drugs)
• Palm Desert Physical Therapy, Inc.

• Pain Clinic/Center in Palm Desert, CA
• Providers in Palm Desert, CA by specialty
• Pain Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.