Pacifica SL Phoenix LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

PACIFICA SL PHOENIX LLC

Doing business as

The Woodmark at Sun City

Practice address

17207 North Boswell Boulevard
Sun City, AZ 85373

Phone

(623) 404-4047

Fax

(623) 583-7433

NPI assigned

Dec 2, 2019

Last updated

Dec 2, 2019By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Deepak Israni

Title

General Manager

Phone

(623) 404-4047

Specialties & licenses 1

Addresses

Other names 1

• The Woodmark at Sun City Doing business as

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

CLIA laboratory certificates

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

{
    "created_epoch": "1575244800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1575244800000",
    "number": "1295372936",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1775 HANCOCK STREET",
            "address_2": "SUITE 200",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "92110",
            "telephone_number": "619-296-9000",
            "fax_number": "619-296-9090"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17207 NORTH BOSWELL BOULEVARD",
            "city": "SUN CITY",
            "state": "AZ",
            "postal_code": "85373",
            "telephone_number": "623-404-4047",
            "fax_number": "623-583-7433"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PACIFICA SL PHOENIX LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-12-02",
        "last_updated": "2019-12-02",
        "status": "A",
        "authorized_official_last_name": "ISRANI",
        "authorized_official_first_name": "DEEPAK",
        "authorized_official_title_or_position": "GENERAL MANAGER",
        "authorized_official_telephone_number": "623-404-4047"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Woodmark at Sun City",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jeffrey D Oliver, M.D.
• Jessica Nicole Oliverson Abel, PA
• Kimberly Ann Olson, COTA/L
• Tamara Louise Overhage
• Jeremiah Bryan Ozuna, FNP-C
• Nika Padyab, DMD
• Theresa Pak, DO
• Srinivasa R Palnati, MD
• Timothy Michael Panknin, MD
• Paul M. Papoff, M.D.

• Assisted Living Facility in Sun City, AZ
• Providers in Sun City, AZ by specialty
• Assisted Living Facility in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 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.