Individual
DR. JOHN DERRICK VAN DOREN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
39000 BOB HOPE DR, RANCHO MIRAGE, CA 92270-3221
(951) 375-7966
Mailing address
42222 RANCHO LAS PALMAS DR UNIT 986, RANCHO MIRAGE, CA 92270-4268
(951) 375-7966
Taxonomy
Speciality
Code
Description
License number
State
207LA0401X
Addiction Medicine (Anesthesiology) Physician
G60750
CA
208D00000X
General Practice Physician
Primary
G60750
CA
Other
Enumeration date
07/25/2019
Last updated
11/09/2021
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