| Senior Doc, Texas PLLC | |
|
2592 N Santiago Blvd Orange CA 92867 | |
| (855) 434-7763 | |
| (949) 281-5550 |
| Full Name | Senior Doc, Texas PLLC |
|---|---|
| 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, Texas PLLC 2592 N Santiago Blvd Orange CA 92867-1862 Ph: (855) 434-7763 | Senior Doc, Texas PLLC 2592 N Santiago Blvd Orange CA 92867 Ph: (855) 434-7763 |
| NPI Number | 1922784701 |
|---|---|
| Provider Enumeration Date | 06/26/2023 |
| Last Update Date | 08/01/2023 |
| Certification Date | 08/01/2023 |
| Medicare PECOS PAC ID | 2769830611 |
|---|---|
| Medicare Enrollment ID | O20231204000029 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1922784701 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | () | Primary |
| Provider Name | Liam Fry |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1952322570 PECOS PAC ID: 1658390471 Enrollment ID: I20060509000770 |
| Provider Name | Michelle Coffey |
|---|---|
| Provider Type | Practitioner - Certified Clinical Nurse Specialist (cns) |
| Provider Identifiers | NPI Number: 1023392461 PECOS PAC ID: 4688840473 Enrollment ID: I20111228000555 |
| Provider Name | Megha Joy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902170269 PECOS PAC ID: 6507010436 Enrollment ID: I20130131000270 |
| Provider Name | John Geiss |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1053651497 PECOS PAC ID: 5890933071 Enrollment ID: I20231204000186 |
| Provider Name | Jeffrey John Thomas |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1932337136 PECOS PAC ID: 7315101003 Enrollment ID: I20240703001622 |
| Provider Name | Anthony Marcus Yniguez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871185686 PECOS PAC ID: 2769882331 Enrollment ID: I20250513000887 |
| Provider Name | Stella Yufenyuy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528890472 PECOS PAC ID: 2567903016 Enrollment ID: I20260128000468 |
| Provider Name | Cassie Kaur Dundon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831685395 PECOS PAC ID: 5092057661 Enrollment ID: I20260212001635 |
| Provider Name | Alexi Yarashevich |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306340831 PECOS PAC ID: 6406119304 Enrollment ID: I20260212001764 |
| Provider Name | Kellie Marie Pacheco |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326728668 PECOS PAC ID: 1951756519 Enrollment ID: I20260213003380 |
| Provider Name | Meredith Alexandra Bock |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1447612940 PECOS PAC ID: 8729339908 Enrollment ID: I20260309003490 |
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