Active NPI
Senior Doc, Mississippi PC
- Family Medicine Physician
- Orange, CA
National Provider Identifier
1326725821
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- Legal business name
- SENIOR DOC, MISSISSIPPI PC
- Practice address
- 2592 N Santiago Blvd
Orange, CA 92867-1862 - Phone
- (855) 434-7763
- Fax
- (949) 281-5550
- NPI assigned
- Jun 28, 2023
- Last updated
- Jun 28, 2023
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- John M Geiss, DO
- Title
- Chief Executive Officer
- Phone
- (855) 434-7763
Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | NU | Primary |
Addresses
Primary practice location
2592 N Santiago Blvd
Orange, CA 92867-1862
Mailing address
2592 N Santiago Blvd
Orange, CA 92867-1862
Phone (855) 434-7763
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
-
- Family Medicine Physician
- Santa Ana, CA
- NPI 1053651497
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1687910400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1687910400000",
"number": "1326725821",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2592 N SANTIAGO BLVD",
"city": "ORANGE",
"state": "CA",
"postal_code": "928671862",
"telephone_number": "855-434-7763",
"fax_number": "949-281-5550"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2592 N SANTIAGO BLVD",
"city": "ORANGE",
"state": "CA",
"postal_code": "928671862",
"telephone_number": "855-434-7763",
"fax_number": "949-281-5550"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "SENIOR DOC, MISSISSIPPI PC",
"organizational_subpart": "NO",
"enumeration_date": "2023-06-28",
"last_updated": "2023-06-28",
"certification_date": "2023-06-28",
"status": "A",
"authorized_official_last_name": "GEISS",
"authorized_official_first_name": "JOHN",
"authorized_official_middle_name": "M",
"authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
"authorized_official_telephone_number": "855-434-7763",
"authorized_official_credential": "DO"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Orange, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.