David Scott Johnson, M.D.
Individual provider Active NPI Surgery Physician · Coachella, CA
NPI 1104910306 · NPPES record last updated Sep 25, 2023
Key facts
- NPI
- 1104910306
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Surgery Physician 208600000X
- License
- A88275 (CA)
- Practice address
- 49305 Grapefruit Blvd Ste 1
Coachella, CA 92236-1490 - Phone
- (760) 398-0723
- NPI assigned
- Oct 3, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 10
Medicare Care Compare profile
- Specialty
- Dermatology
- Education
- University of Hawaii John a. Burns School of Medicine, 1999
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Advanced Dermatology and Skin Cancer Specialists
Practice addresses (Care Compare)
9889 Magnolia Ave
Suite a
Riverside, CA 92503-3581
Phone (951) 525-3548
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Melanoma (skin cancer) excision | 1-10 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (3 enrollments) in CA, SD, OR
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20090821000255 | CA | Practitioner - Dermatology |
3971501891 | Reassigns benefits to 3 organizations |
| I20180807000713 | SD | Practitioner - General Surgery | 3971501891 | Reassigns benefits to 1 organization |
| I20181012000973 | OR | Practitioner - General Surgery | 3971501891 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A88275 | CA | MD | Surgery Physician |
| 12949 | HI | MD | Surgery Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Bay Area Hospital District | Current |
Accepting new patients | |
| Bay Area Hospital District | Current |
Accepting new patients | |
| Monument Health Network, Inc. | Current |
Accepting new patients | |
| Mark Twain Medical Center | Current |
Accepting new patients | |
| Emergency Associates Corporation | Current |
Accepting new patients | |
| Monument Health Network, Inc. | Current |
Accepting new patients | |
| Occupational Orthopedic Medical Group | Current | Accepting new patients | |
| Advanced Dermatology & Skin Cancer Specialists | Current |
Accepting new patients | |
| Frances Mahon Deaconess Hospital | Past | Accepting new patients | |
| Edmund Yao MD Inc | Past |
Accepting new patients |
Locations
49305 Grapefruit Blvd
Ste 1
Coachella, CA 92236
Phone (760) 391-9062
800 E Washington Blvd
Crescent City, CA 95531
Phone (707) 464-8511
47647 Caleo Bay Dr
Ste 120
La Quinta, CA 92253
Phone (760) 564-8200
1150 N Indian Canyon Dr
Palm Springs, CA 92262
Phone (760) 323-6251
Dept LA 25339
Pasadena, CA 91185
9889 Magnolia Ave
Ste A
Riverside, CA 92503
Phone (951) 525-3548
768 Mountain Ranch Rd
San Andreas, CA 95249
Phone (209) 464-6422
1507 E March Ln
Ste C
Stockton, CA 95210
Phone (209) 227-5052
31938 Temecula Pkwy
Ste A337
Temecula, CA 92592
Phone (951) 303-6900
31938 Temecula Pkwy
#A337
Temecula, CA 92592
Phone (951) 417-4032
31150 Temecula Pkwy
Ste 104
Temecula, CA 92592
Phone (951) 303-2100
437 Del Norte Ave
Yuba City, CA 95991
Phone (530) 443-2759
2650 N 17th St
Coos Bay, OR 97420
Phone (541) 267-5411
1440 N Main St
Spearfish, SD 57783
Phone (605) 644-4000
1445 North Ave
Spearfish, SD 57783
Phone (605) 347-2536
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician | 208600000X | 12949 | HI | |
| Surgery Physician | 208600000X | A88275 | CA | Yes |
Addresses
Primary practice location
49305 Grapefruit Blvd Ste 1
Coachella, CA 92236-1490
Mailing address
31938 Temecula Pkwy Ste A337
Temecula, CA 92592-6810
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| A88275 | Other | CA | CALIFORNIA MEDICAL BOARD |
Other providers in Coachella, CA
- Indio Emergency Medical Group
- Indio Emergency Medical Group Inc
- Elizabeth Jaime Infante
- Samantha Faith Joe
- Sooho Joe
- Anthony Eugene Jordan
- Byran William Kaul Sr.
- Sandy H Kim
- Faustino Ramon King
- Kavonna Faye Kirksey
All providers in Coachella, CA · Surgery Physician in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 25, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.