| Senior Doc Oregon, Pc | |
|
2592 N Santiago Blvd Orange CA 92867-1862 | |
| (855) 434-7763 | |
| (949) 281-5550 |
| Full Name | Senior Doc Oregon, Pc |
|---|---|
| Speciality | Family Medicine |
| Location | 2592 N Santiago Blvd, Orange, California |
| Authorized Official Name and Position | John Mark Geiss (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Contact | 8554347763 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Senior Doc Oregon, Pc 2592 N Santiago Blvd Orange CA 92867-1862 Ph: (855) 434-7763 | Senior Doc Oregon, Pc 2592 N Santiago Blvd Orange CA 92867-1862 Ph: (855) 434-7763 |
| NPI Number | 1063192029 |
|---|---|
| Provider Enumeration Date | 07/24/2023 |
| Last Update Date | 07/24/2023 |
| Medicare PECOS PAC ID | 0749643716 |
|---|---|
| Medicare Enrollment ID | O20230824001983 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1063192029 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Chameka I Taylor |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104597525 PECOS PAC ID: 0941690069 Enrollment ID: I20220913003705 |
| Provider Name | John Mark Geiss |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1053651497 PECOS PAC ID: 5890933071 Enrollment ID: I20230928002351 |
| Provider Name | Sarah B Chandler |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720144793 PECOS PAC ID: 2961889381 Enrollment ID: I20231102000841 |
| Provider Name | Jeffrey John Thomas |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1932337136 PECOS PAC ID: 7315101003 Enrollment ID: I20240316000535 |
| Provider Name | April K. Withers |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1215512538 PECOS PAC ID: 3274942115 Enrollment ID: I20240426000660 |
| Provider Name | Anthony Yniguez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871185686 PECOS PAC ID: 2769882331 Enrollment ID: I20240513000068 |
| Provider Name | Christina Nelson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790499218 PECOS PAC ID: 1759753098 Enrollment ID: I20240710004742 |
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