Senior Doc Oregon, Pc | |
2592 N Santiago Blvd Orange CA 92867-1862 | |
(855) 434-7763 | |
(949) 281-5550 |
Full Name | Senior Doc Oregon, Pc |
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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 |
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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 |
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Provider Enumeration Date | 07/24/2023 |
Last Update Date | 07/24/2023 |
Medicare PECOS PAC ID | 0749643716 |
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Medicare Enrollment ID | O20230824001983 |
Identifier | Type | State | Issuer |
---|---|---|---|
1063192029 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Primary |
Provider Name | John M Geiss |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1053651497 PECOS PAC ID: 5890933071 Enrollment ID: I20230928002351 |
Provider Name | Sarah B Chandler |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1720144793 PECOS PAC ID: 2961889381 Enrollment ID: I20231102000841 |
Provider Name | Jeffrey John Thomas |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1932337136 PECOS PAC ID: 7315101003 Enrollment ID: I20240316000535 |
Provider Name | Anthony Yniguez |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1871185686 PECOS PAC ID: 2769882331 Enrollment ID: I20240513000068 |
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