Provider Demographics
NPI:1245255041
Name:COMUNALE, MARK E (MD)
Entity type:Individual
Prefix:
First Name:MARK
Middle Name:E
Last Name:COMUNALE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 765
Mailing Address - Street 2:INLAND EMPIRE ANESTHESIA MEDICAL GROUP, INC.
Mailing Address - City:COLTON
Mailing Address - State:CA
Mailing Address - Zip Code:92324-0800
Mailing Address - Country:US
Mailing Address - Phone:978-918-3686
Mailing Address - Fax:909-580-2440
Practice Address - Street 1:400 N PEPPER AVE
Practice Address - Street 2:DEPARTMENT OF ANESTHESIOLOGY, 2ND FLOOR
Practice Address - City:COLTON
Practice Address - State:CA
Practice Address - Zip Code:92324-1801
Practice Address - Country:US
Practice Address - Phone:909-580-2440
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-13
Last Update Date:2014-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2002030173207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO206009201Medicaid
247307OtherHARMONY ID NUMBER
888771OtherCOMMUNITY CARE PLUS
79493OtherHEALTH ALLIANCE
1847OtherBLUE CROSS BLUE SHIELD
MO50091321OtherMEDICARE RAILROAD
888771OtherCOMMUNITY CARE PLUS
1847OtherBLUE CROSS BLUE SHIELD