John Derrick Van Doren, MD

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

G60750 Issued in CA

Practice address

39000 Bob Hope Dr
Rancho Mirage, CA 92270-3221

Phone

(951) 375-7966

NPI assigned

Jul 25, 2019

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• California Hospitalists Emergency Physicians Medical Group Inc

  • Emergency Medicine Physician
  • Norwalk, CA
  • NPI 1760648539
  NPD
• ER Physicians Medical Group, Inc.

  • Emergency Medicine Physician
  • Los Angeles, CA
  • NPI 1063765907
  NPD
• KND Development 59 LLC

  • Hospitalist Physician
  • La Mirada, CA
  • NPI 1710216049
  NPD
• KND Development 59 LLC

  • Hospitalist Physician
  • Santa Ana, CA
  • NPI 1740519081
  NPD
• KND Development 59, LLC

  • Hospitalist Physician
  • Broken Arrow, OK
  • NPI 1922950823
  NPD

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

{
    "created_epoch": "1564012800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636416000000",
    "number": "1841844115",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "42222 RANCHO LAS PALMAS DR UNIT 986",
            "city": "RANCHO MIRAGE",
            "state": "CA",
            "postal_code": "922704268",
            "telephone_number": "951-375-7966"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "39000 BOB HOPE DR",
            "city": "RANCHO MIRAGE",
            "state": "CA",
            "postal_code": "922703221",
            "telephone_number": "951-375-7966"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAN DOREN",
        "first_name": "JOHN",
        "middle_name": "DERRICK",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-07-25",
        "last_updated": "2021-11-09",
        "certification_date": "2021-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207LA0401X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Addiction Medicine",
            "state": "CA",
            "license": "G60750",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "CA",
            "license": "G60750",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Timothy Michael Valdez, PA-C
• Alynna Lizlane Valenzuela
• Valerie Valenzuela
• Valley Medplus Home Health Care
• Valley Urologic Medical Group Inc
• Carole A Van Straten, HAD
• Vijay Kumar Vanam, M.D
• Quinten M Vanderwerf, MEDICAL DORCTOR
• Matthew Varallo, D.O.
• Carlos Eduardo Vargas Huerta, BA, RBT

• General Practice Physician in Rancho Mirage, CA
• Providers in Rancho Mirage, CA by specialty
• General Practice Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.