MEDICARE: RODERICK A COMUNALE II MD INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RN0300X	Nephrology Physician	A43885	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1033172002
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RODERICK A COMUNALE II MD INC

Provider Business Mailing Address
First Line	:	PO BOX 1188
Second Line	:
City	:	LA JOLLA
State	:	CA
Zip	:	92038-1188
Country	:	US
Telephone Number	:	858-551-0276
Fax Number	:	858-454-9796

Provider Business Practice Location Address
First Line	:	502 EUCLID AVE STE 205
Second Line	:
City	:	NATIONAL CITY
State	:	CA
Zip	:	91950-2993
Country	:	US
Telephone Number	:	858-551-0276
Fax Number	:	848-454-9796

Authorized Official
Title or Position	:	OWNER
Name	:	DR. RODERICK A COMUNALE
Credential	:	MD
Telephone Number	:	858-551-0276

Provider Enumeration Date	:	04/10/2006
Last Update Date	:	02/01/2024

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