NPIMap

Organization Active NPI

Gary and Mary West Senior Services, Inc.

Doing business as Gary and Mary West PACE

  • PACE Provider Organization
  • San Marcos, CA
National Provider Identifier
1295249035
Registry record updated Dec 10, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
PACE Provider OrganizationTaxonomy code 251T00000X
Legal business name
GARY AND MARY WEST SENIOR SERVICES, INC.
Doing business as
Gary and Mary West PACE
Practice address
1706 Descanso Ave
San Marcos, CA 92078-2514
Phone
(858) 412-7000
NPI assigned
Nov 30, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 10, 2019

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

Authorized official

Name
Kannamma Kannan
Title
Qi and Compliance Director
Phone
(760) 280-2232

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PACE Provider Organization 251T00000X Primary

Addresses

Primary practice location

1706 Descanso Ave
San Marcos, CA 92078-2514

Mailing address

1706 Descanso Ave
San Marcos, CA 92078-2514
Phone (760) 280-2230

Other names 1

  • Gary and Mary West PACE Doing business as

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
05D2159675Gary and Mary West Senior Services, Inc1706 Descanso Avenue, San Marcos, CA 92078Certificate of waiverDec 20, 2026

National Provider Directory

National Provider Directory

Locations

10350 N Torrey Pines Rd
La Jolla, CA 92037

1706 Descanso Ave
San Marcos, CA 92078
Phone (760) 280-2230

Practitioners & affiliated clinicians

Practitioners 11

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

NPI Registry JSON

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

{
    "created_epoch": "1512000000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1575936000000",
    "number": "1295249035",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1706 DESCANSO AVE",
            "city": "SAN MARCOS",
            "state": "CA",
            "postal_code": "920782514",
            "telephone_number": "760-280-2230"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1706 DESCANSO AVE",
            "city": "SAN MARCOS",
            "state": "CA",
            "postal_code": "920782514",
            "telephone_number": "858-412-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GARY AND MARY WEST SENIOR SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-11-30",
        "last_updated": "2019-12-10",
        "certification_date": "2019-12-10",
        "status": "A",
        "authorized_official_last_name": "KANNAN",
        "authorized_official_first_name": "KANNAMMA",
        "authorized_official_title_or_position": "QI AND COMPLIANCE  DIRECTOR",
        "authorized_official_telephone_number": "760-280-2232"
    },
    "taxonomies": [
        {
            "code": "251T00000X",
            "taxonomy_group": "",
            "desc": "Program of All-Inclusive Care for the Elderly (PACE) Provider Organization",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Gary and Mary West PACE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in San Marcos, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.