Organization
PAIN REHABILITATION & CRITICAL CARE MEDICAL GROUP, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARK E COMUNALE MD (PRESIDENT)
(909) 580-2440
Entity
Organization
Contact information
Practice address
400 N PEPPER AVE, 2ND FLOOR-DEPT. OF ANESTHESIA, COLTON, CA 92324-1801
(909) 580-2440
Mailing address
PO BOX 765, COLTON, CA 92324-0800
(909) 580-2439
(909) 580-2441
Taxonomy
Speciality
Code
Description
License number
State
207LC0200X
Critical Care Medicine (Anesthesiology) Physician
FNP36389
CA
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
FNP36389
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
FNP36389
FICTITIOUS NAME PERMIT
CA
Enumeration date
10/09/2007
Last updated
03/03/2008
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