| Senior Doc Virginia PC | |
|
5 Hutton Centre Dr Ste 950 Santa Ana CA 92707-8744 | |
| (855) 434-7763 | |
| (949) 281-5550 |
| Full Name | Senior Doc Virginia PC |
|---|---|
| Speciality | Family Medicine |
| Location | 5 Hutton Centre Dr Ste 950, Santa Ana, California |
| Authorized Official Name and Position | John Geiss (CEO) |
| Authorized Official Contact | 6573150858 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Senior Doc Virginia PC 5 Hutton Centre Dr Ste 950 Santa Ana CA 92707-8744 Ph: (855) 434-7763 | Senior Doc Virginia PC 5 Hutton Centre Dr Ste 950 Santa Ana CA 92707-8744 Ph: (855) 434-7763 |
| NPI Number | 1669352704 |
|---|---|
| Provider Enumeration Date | 09/08/2025 |
| Last Update Date | 09/08/2025 |
| Certification Date | 09/07/2025 |
| Medicare PECOS PAC ID | 7012402696 |
|---|---|
| Medicare Enrollment ID | O20251220000523 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1669352704 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | () | Primary |
| Provider Name | Henriette Solyst Hvingelby |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942353107 PECOS PAC ID: 2668570979 Enrollment ID: I20160707001720 |
| Provider Name | John Dennis Broderick |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1588666424 PECOS PAC ID: 8729038070 Enrollment ID: I20230210000659 |
| Provider Name | Jeffrey John Thomas |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1932337136 PECOS PAC ID: 7315101003 Enrollment ID: I20250319001216 |
| Provider Name | John Geiss |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1053651497 PECOS PAC ID: 5890933071 Enrollment ID: I20250818001257 |
| Provider Name | Kellie Marie Pacheco |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326728668 PECOS PAC ID: 1951756519 Enrollment ID: I20260105002756 |
| Provider Name | Farrah Selah Jallalvandi |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770317448 PECOS PAC ID: 6002348034 Enrollment ID: I20260220000018 |
| Provider Name | Francis Peter Lagattuta |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1457725723 PECOS PAC ID: 2264834696 Enrollment ID: I20260226000288 |
| Provider Name | Deante Jemel Markey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982393716 PECOS PAC ID: 6901256569 Enrollment ID: I20260227003084 |
| Provider Name | Rachelle Marie Virgin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1578341913 PECOS PAC ID: 9234588062 Enrollment ID: I20260421000475 |
| Provider Name | Christine M. Padilla |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1386897262 PECOS PAC ID: 6305991670 Enrollment ID: I20260423000812 |
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