Pacifica SL Scottsdale LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

AL10612C Issued in AZ

Legal business name

PACIFICA SL SCOTTSDALE LLC

Doing business as

Scottsdale Village Square

Practice address

2620 N. 68TH Street
Scottsdale, AZ 85257

Phone

(480) 946-6571

Fax

(480) 946-0028

NPI assigned

Feb 6, 2018

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

Managing Partner

Phone

(619) 296-9000

Specialties & licenses 1

Addresses

Other names 1

• Scottsdale Village Square Doing business as

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

{
    "created_epoch": "1517875200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1517875200000",
    "number": "1497254486",
    "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": "2620 N. 68TH STREET",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "85257",
            "telephone_number": "480-946-6571",
            "fax_number": "480-946-0028"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PACIFICA SL SCOTTSDALE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-02-06",
        "last_updated": "2018-02-06",
        "status": "A",
        "authorized_official_last_name": "ISRANI",
        "authorized_official_first_name": "DEEPAK",
        "authorized_official_title_or_position": "MANAGING PARTNER",
        "authorized_official_telephone_number": "619-296-9000"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "AZ",
            "license": "AL10612C",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Scottsdale Village Square",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Maria Jose Pachon, MD
• Linda S Pachuta
• Pacific Coast Psychiatric Associates Inc (Lifestance Health)
• Pacific Sonoran Anesthesia LLC
• Pacifica SL Scottsdale LLC (Scottsdale Village Square)
• Lucia Pacurar
• Joselito R Padaoan, PTA
• Michele C Paden, PA-C
• Thomas Padilla, D.P.T.
• Nimmi Padmini Babu

• Assisted Living Facility in Scottsdale, AZ
• Providers in Scottsdale, 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 Feb 6, 2018; 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.