Gary Mitchell Westbrock, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA16139 Issued in CA

Practice address

715 Tank Farm Rd Ste a
San Luis Obispo, CA 93401-7068

Phone

(805) 541-4018

Fax

(805) 543-6271

NPI assigned

Mar 23, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Gary M. Westbrock, Physician Assistant, Inc.

  • Physician Assistant
  • San Luis Obispo, CA
  • NPI 1205514510
  NPD Authorized official
• San Luis Dermatology, Inc.

  • Dermatology Physician
  • San Luis Obispo, CA
  • NPI 1568431500
  NPD (past)

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

{
    "created_epoch": "1143072000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732579200000",
    "number": "1053371377",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2603 SILVERWOOD WAY",
            "city": "PASO ROBLES",
            "state": "CA",
            "postal_code": "934464763",
            "telephone_number": "805-541-4018",
            "fax_number": "805-543-6271"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "715 TANK FARM RD STE A",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "934017068",
            "telephone_number": "805-541-4018",
            "fax_number": "805-543-6271"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WESTBROCK",
        "first_name": "GARY",
        "middle_name": "MITCHELL",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-23",
        "last_updated": "2024-11-26",
        "certification_date": "2024-11-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA16139",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Clea Rose Wendt
• Shari Marie Wenzel, LVN
• Megan Munro Werner
• Laura Quaglino Weronski, LMFT
• West Los Angeles Vamc
• Western Pathology Inc
• Amanda Westman, DO
• Pamela Westphal
• Paul D Wetzel, M.D.
• Laurie A. Weymann, N.P.

• Physician Assistant in San Luis Obispo, CA
• Providers in San Luis Obispo, CA by specialty
• Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.