Sip DC Ca, Inc

Primary specialty

Geriatric Medicine (Family Medicine) PhysicianTaxonomy code 207QG0300X

Legal business name

SIP DC CA, INC

Practice address

600 Anton Blvd Ste 1100
Costa Mesa, CA 92626-7100

Phone

(800) 388-3906

NPI assigned

Feb 20, 2015

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Glenn Fortich

Title

Revenue Cycle Management Director

Phone

(626) 893-9730

Specialties & licenses 2

Addresses

Other names 1

• MD24 CA Inc Former legal business name

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Judith Rivera, NP

  • Nurse Practitioner
  • Costa Mesa, CA
  • NPI 1023425352

  Single Specialty

  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1424390400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1621900800000",
    "number": "1588056014",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 ANTON BLVD STE 1100",
            "city": "COSTA MESA",
            "state": "CA",
            "postal_code": "926267100",
            "telephone_number": "800-388-3906"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 ANTON BLVD STE 1100",
            "city": "COSTA MESA",
            "state": "CA",
            "postal_code": "926267100",
            "telephone_number": "800-388-3906"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "175 N Jackson Ave Ste 101",
            "address_purpose": "LOCATION",
            "city": "San Jose",
            "state": "CA",
            "postal_code": "951161909",
            "country_code": "US",
            "telephone_number": "623-374-7774",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "SIP DC CA, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-02-20",
        "last_updated": "2021-05-25",
        "certification_date": "2021-05-25",
        "status": "A",
        "authorized_official_last_name": "FORTICH",
        "authorized_official_first_name": "GLENN",
        "authorized_official_title_or_position": "REVENUE CYCLE MANAGEMENT DIRECTOR",
        "authorized_official_telephone_number": "626-893-9730",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207QG0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MD24 CA Inc",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "MD24 CA Inc",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Casey Singer
• Jaskiran Singh
• Tamisha Singh
• Jazmin Marie Singletary
• Angela Sinnett, L.AC
• Sarahi Siqueiros Villa
• Janelle Siqueiros
• Lawrence Sistoso, RN
• Sabrina Skelton
• Nikol Skerlep

• Geriatric Medicine (Family Medicine) Physician in Costa Mesa, CA
• Providers in Costa Mesa, CA by specialty
• Geriatric Medicine (Family Medicine) Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.