Organization Active NPI

John J Lee MD a Professional Corporation

  • Vascular Surgery Physician
  • Rancho Mirage, CA
National Provider Identifier
1780040840
Registry record updated Jul 24, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
Legal business name
JOHN J LEE MD A PROFESSIONAL CORPORATION
Practice address
35400 Bob Hope Dr Ste 103&104
Rancho Mirage, CA 92270-1708
Phone
(760) 875-2116
Fax
(760) 266-6184
NPI assigned
Jan 5, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 24, 2026

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

Authorized official

Name
Mr. Tayyab Waseem
Title
Credentialling Manager
Phone
(760) 565-3554

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2086S0129X Primary

Addresses

Primary practice location

35400 Bob Hope Dr Ste 103&104
Rancho Mirage, CA 92270-1708

Mailing address

35400 Bob Hope Dr Ste 103
Rancho Mirage, CA 92270-1772
Phone (760) 875-2116

Other practice location 1

39000 Bob Hope Dr
Rancho Mirage, CA 92270-3221
Phone (760) 875-2116

Other practice location 2

1150 N Indian Canyon Dr
Palm Springs, CA 92262-4872
Phone (760) 875-2116

Other practice location 3

47111 Monroe St
Indio, CA 92201-6739
Phone (760) 875-2116

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240325002266 CA Part B Supplier - Clinic/Group Practice 7012354160 Receives reassigned benefits from 1 practitioner
Practice locations: Indio, CA; Palm Springs, CA; Rancho Mirage, CA

National Provider Directory

National Provider Directory

Locations

35400 Bob Hope Dr
Ste 103
Rancho Mirage, CA 92270
Phone (760) 844-7844

35400 Bob Hope Dr
Ste 104
Rancho Mirage, CA 92270

35400 Bob Hope Dr
Ste 103104
Rancho Mirage, CA 92270
Phone (760) 875-2116

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1451952000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1784851200000",
    "number": "1780040840",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "35400 BOB HOPE DR STE 103",
            "city": "RANCHO MIRAGE",
            "state": "CA",
            "postal_code": "922701772",
            "telephone_number": "760-875-2116",
            "fax_number": "760-266-6184"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "35400 BOB HOPE DR STE 103&104",
            "city": "RANCHO MIRAGE",
            "state": "CA",
            "postal_code": "922701708",
            "telephone_number": "760-875-2116",
            "fax_number": "760-266-6184"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "39000 Bob Hope Dr",
            "address_purpose": "LOCATION",
            "city": "Rancho Mirage",
            "state": "CA",
            "postal_code": "922703221",
            "country_code": "US",
            "telephone_number": "760-875-2116",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1150 N Indian Canyon Dr",
            "address_purpose": "LOCATION",
            "city": "Palm Springs",
            "state": "CA",
            "postal_code": "922624872",
            "country_code": "US",
            "telephone_number": "760-875-2116",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "47111 Monroe St",
            "address_purpose": "LOCATION",
            "city": "Indio",
            "state": "CA",
            "postal_code": "922016739",
            "country_code": "US",
            "telephone_number": "760-875-2116",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "JOHN J LEE MD A PROFESSIONAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-01-05",
        "last_updated": "2026-07-24",
        "certification_date": "2026-07-24",
        "status": "A",
        "authorized_official_last_name": "WASEEM",
        "authorized_official_first_name": "TAYYAB",
        "authorized_official_title_or_position": "CREDENTIALLING MANAGER",
        "authorized_official_telephone_number": "760-565-3554",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery, Vascular Surgery",
            "state": null,
            "license": null,
            "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 Jul 24, 2026; 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.