Organization Active NPI

V Douglas Jodoin MD Inc

  • General Practice Physician
  • Rancho Mirage, CA
National Provider Identifier
1689885402
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
G40824 Issued in CA
Legal business name
V DOUGLAS JODOIN MD INC
Practice address
39000 Bob Hope Dr Ste W208
Rancho Mirage, CA 92270-7013
Phone
(760) 773-3950
NPI assigned
May 24, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. V Douglas Jodoin, MDNPI 1225016074
Title
President
Phone
(760) 773-3950

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208D00000X G40824 CA Primary

Addresses

Primary practice location

39000 Bob Hope Dr Ste W208
Rancho Mirage, CA 92270-7013

Mailing address

39000 Bob Hope Dr Ste W208
Rancho Mirage, CA 92270-7013
Phone (760) 773-3950

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110428000082 CA Part B Supplier - Clinic/Group Practice 9830374271 Receives reassigned benefits from 1 practitioner
Practice locations: Rancho Mirage, CA

National Provider Directory

National Provider Directory

Locations

39000 Bob Hope Dr
Ste W208
Rancho Mirage, CA 92270
Phone (619) 568-9831

39000 Bob Hope Dr
Ste K112
Rancho Mirage, CA 92270
Phone (760) 773-3950

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1179964800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1689885402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "39000 BOB HOPE DR STE W208",
            "city": "RANCHO MIRAGE",
            "state": "CA",
            "postal_code": "922707013",
            "telephone_number": "760-773-3950"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "39000 BOB HOPE DR STE W208",
            "city": "RANCHO MIRAGE",
            "state": "CA",
            "postal_code": "922707013",
            "telephone_number": "760-773-3950"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "V DOUGLAS JODOIN MD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-24",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "JODOIN",
        "authorized_official_first_name": "V DOUGLAS",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "760-773-3950",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "General Practice",
            "state": "CA",
            "license": "G40824",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rancho Mirage, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.