| Senior Doc Id Medical, PC | |
|
2592 N Santiago Blvd Orange CA 92867-1862 | |
| (855) 434-7763 | |
| (949) 281-5550 |
| Full Name | Senior Doc Id Medical, PC |
|---|---|
| Speciality | Family Medicine |
| Location | 2592 N Santiago Blvd, Orange, California |
| Authorized Official Name and Position | John M 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 Id Medical, PC 2592 N Santiago Blvd Orange CA 92867-1862 Ph: (855) 434-7763 | Senior Doc Id Medical, PC 2592 N Santiago Blvd Orange CA 92867-1862 Ph: (855) 434-7763 |
| NPI Number | 1407639941 |
|---|---|
| Provider Enumeration Date | 08/17/2023 |
| Last Update Date | 08/17/2023 |
| Certification Date | 08/17/2023 |
| Medicare PECOS PAC ID | 0840632469 |
|---|---|
| Medicare Enrollment ID | O20240529001032 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1407639941 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | () | Primary |
| Provider Name | Janeen D Jenkins |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1851469050 PECOS PAC ID: 8921191206 Enrollment ID: I20070831000268 |
| Provider Name | Melissa Walsh |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1821304007 PECOS PAC ID: 5991994196 Enrollment ID: I20110104000383 |
| Provider Name | Sharon L Bennett |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598189821 PECOS PAC ID: 1658594049 Enrollment ID: I20140604000901 |
| Provider Name | Daniel Brian Mcconnell |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1376888735 PECOS PAC ID: 7618299900 Enrollment ID: I20210928003634 |
| Provider Name | Angela Rae Larkins |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871249474 PECOS PAC ID: 0345636452 Enrollment ID: I20220329001766 |
| Provider Name | Samantha M Hoskins |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265134985 PECOS PAC ID: 5294196267 Enrollment ID: I20230807003692 |
| Provider Name | Jeffrey John Thomas |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1932337136 PECOS PAC ID: 7315101003 Enrollment ID: I20240502002915 |
| Provider Name | John Geiss |
|---|---|
| Provider Type | Practitioner - Osteopathic Manipulative Medicine |
| Provider Identifiers | NPI Number: 1053651497 PECOS PAC ID: 5890933071 Enrollment ID: I20240530001815 |
| Provider Name | Alexi Yarashevich |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306340831 PECOS PAC ID: 6406119304 Enrollment ID: I20240624001113 |
| Provider Name | Nicole Frankle |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467729525 PECOS PAC ID: 5496013716 Enrollment ID: I20240705000758 |
| Provider Name | Anthony Marcus Yniguez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871185686 PECOS PAC ID: 2769882331 Enrollment ID: I20240711002230 |
| Provider Name | Rebecca Riehle |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1629769542 PECOS PAC ID: 6204363005 Enrollment ID: I20241218000437 |
| Provider Name | Joseph Machtinger |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245068691 PECOS PAC ID: 6800324732 Enrollment ID: I20250106003395 |
| Provider Name | Steven L Berry |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1528095312 PECOS PAC ID: 9436213469 Enrollment ID: I20250422001325 |
| Provider Name | Emily Grace Lesuer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538999461 PECOS PAC ID: 2466961438 Enrollment ID: I20250602001280 |
| Provider Name | Meredith Alexandra Bock |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1447612940 PECOS PAC ID: 8729339908 Enrollment ID: I20260219003995 |
| Provider Name | Robert Charles Morse |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356194005 PECOS PAC ID: 0143766287 Enrollment ID: I20260320001491 |
| Provider Name | Christina Nelson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790499218 PECOS PAC ID: 1759753098 Enrollment ID: I20260403001581 |
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