NPIMap

Organization Active NPI

Glendale Adventist Medical Center

Doing business as Adventist Health Glendale

  • Skilled Nursing Facility
  • Glendale, CA
National Provider Identifier
1114916293
Registry record updated Nov 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
930000059 Issued in CA
Legal business name
GLENDALE ADVENTIST MEDICAL CENTER
Doing business as
Adventist Health Glendale
Practice address
1509 Wilson Ter
Glendale, CA 91206-4007
Phone
(818) 409-8000
Fax
(818) 546-5600
NPI assigned
Oct 20, 2005
Last updated
Nov 13, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 13, 2025

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

Authorized official

Name
Alice Issai
Title
Ceo/President
Phone
(818) 409-8289

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 930000059 CA Primary

Addresses

Primary practice location

1509 Wilson Ter
Glendale, CA 91206-4007

Mailing address

1509 Wilson Ter
Glendale, CA 91206-4007
Phone (818) 409-8000

Other identifiers 1

IdentifierTypeStateIssuer
LTC55419FMedicaidCA

Other names 1

  • Adventist Health Glendale Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://esmd.officeally.io:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service Other Bluemark LLC / Office Ally

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170717002101 CA Part A Provider - Skilled Nursing Facility 4284692096 Practice locations: Glendale, CA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1114916293. Details of each certification follow.

Skilled nursing facility certification: CCN 555911

Legal name
GLENDALE ADVENTIST MEDICAL CENTER
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF distinct part
Participating since
Apr 18, 2019
Last certification
Aug 18, 2024
Beds
40
Ownership / control type
Partnership
Organization structure
CorporationNon-profit
Incorporated
Aug 26, 1905 in CA
Enrollment address
1509 Wilson Ter
Glendale, CA 91206-4007
Nursing home name
GLENDALE ADVENTIST MEDICAL CENTER DP/SNF
Affiliated entity
ADVENTIST HEALTH

Other NPIs with the same Medicare PAC ID 4

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Care Compare: Nursing home

Medicare Care Compare
Listed as
Glendale Adventist Medical Center DP/SNFCCN 555911 · All quality measures
Overall star rating
5 of 5
Health inspections
5 of 5
Staffing
5 of 5
Quality measures
4 of 5
Type
Medicare and Medicaid
Ownership
For profit - Partnership
Certified
Apr 18, 2019
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
4038.8 residents per day on average
Chain
Adventist Health5 facilities in the chain

Processed by Care Compare on Aug 1, 2026.

National Provider Directory

National Provider Directory

Locations (25 of 38)

191 S Buena Vista St
Ste 150
Burbank, CA 91505
Phone (818) 295-5920

500 E Olive Ave
Ste 750
Burbank, CA 91501
Phone (818) 244-4114

1661 Hanover Rd
City of Industry, CA 91748
Phone (626) 965-8801

275 Victoria St
Ste 2K
Costa Mesa, CA 92627
Phone (714) 631-1209

12442 Limonite Ave
Unit 203
Eastvale, CA 91752
Phone (951) 821-5188

1030 S Glendale Ave
Ste 308
Glendale, CA 91205
Phone (818) 265-1255

1111 N Brand Blvd
Ste 320
Glendale, CA 91202
Phone (626) 440-9920

1510 S Central Ave
Ste 450
Glendale, CA 91204
Phone (818) 500-8822

1530 E Chevy Chase Dr
Ste 107
Glendale, CA 91206
Phone (661) 705-9706

1560 E Chevy Chase Dr
Ste 225
Glendale, CA 91206
Phone (626) 797-9883

1808 Verdugo Blvd
Ste 102
Glendale, CA 91208
Phone (818) 952-1136

1808 Verdugo Blvd
Ste 408
Glendale, CA 91208
Phone (818) 952-3075

1809 Verdugo Blvd
Ste 350
Glendale, CA 91208
Phone (818) 790-8121

1818 Verdugo Blvd
Ste 207
Glendale, CA 91208
Phone (818) 330-7977

2101 Broadview Dr
Glendale, CA 91208
Phone (818) 357-2200

330 N Brand Blvd
Ste 190
Glendale, CA 91203
Phone (818) 240-1820

500 N Central Ave
Ste 900
Glendale, CA 91203
Phone (818) 244-1732

662 W Broadway
Ste C
Glendale, CA 91204
Phone (818) 664-4112

800 S Central Ave
Ste 101B
Glendale, CA 91204
Phone (818) 649-1433

1109 Foothill Blvd
La Canada, CA 91011
Phone (562) 869-1322

1150 Foothill Blvd
Ste C
La Canada Flintridge, CA 91011
Phone (818) 369-7848

1975 Verdugo Blvd
Ste B
La Canada Flintridge, CA 91011
Phone (818) 541-1134

1701 E Cesar E Chavez Ave
Ste 306
Los Angeles, CA 90033
Phone (323) 225-2550

1701 E Cesar E Chavez Ave
Ste 402
Los Angeles, CA 90033
Phone (323) 255-5643

1704 Colorado Blvd
Los Angeles, CA 90041
Phone (323) 256-4116

Ownership & related parties

All disclosed owners & managing parties 20

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Robert M Bonner Individual Corporate OfficerTreasurer Oct 25, 2021
W-2 Managing Employee Oct 25, 2021
Melody L Gabriel Individual Corporate DirectorBoard Member Jun 1, 2015
Kerry L Heinrich Individual Corporate DirectorBoard Member Dec 16, 2014
Velino a Salazar Individual Corporate DirectorBoard Member Sep 15, 2015
James E Pedersen Individual Corporate DirectorBoard Member Jan 16, 2017
Meredith S Jobe Individual Corporate OfficerSecretary Mar 31, 2014
Ricardo B Graham Individual Corporate DirectorBoard Member Dec 17, 2007
Alice H Issai Individual Corporate OfficerPresident Jul 2, 2018
W-2 Managing EmployeePresident Jul 2, 2018
Richard K Reiner Individual Corporate DirectorBoard Member Jan 16, 2017
Andrew R Davis Individual Corporate DirectorBoard Member May 5, 2017
Billy D Wing Individual Corporate OfficerVice Chair/Assistant Secretary Mar 31, 2014
Corporate DirectorVice Chair/Assistant Secretary Mar 31, 2014
Wesley E Rippey Individual Corporate DirectorBoard Member Sep 14, 1998
David P Banks Individual Corporate DirectorBoard Member May 5, 2017
John C Freedman Individual Corporate DirectorBoard Member Sep 26, 2016
Jack W Wagner Individual Corporate OfficerAsst Secretary Mar 31, 2014
Brian S Reiner Individual Corporate OfficerChairman of the Board Mar 31, 2014
Corporate DirectorChairman of the Board Mar 31, 2014
Robert a Cherry Individual Corporate DirectorBoard Member May 5, 2017
Larry L Innocent Individual Corporate DirectorBoard Member Sep 19, 2011
Adventist Health System/West Organization, Roseville, CA Non-profit 5% Or Greater Direct Ownership Interest Jun 16, 1980 100%
Operational/Managerial Control Jun 16, 1980 100%
Warren Tetz Individual Corporate OfficerAssisant Secretary Sep 14, 1999
W-2 Managing EmployeeSr VP Operations/Coo Sep 14, 1999

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Facilities with the same owner 105

Facilities that share an organizational owner with 5% or greater ownership or operational control.

View all 105

Practitioners & affiliated clinicians

Practitioners 504

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 504

Affiliated clinicians 28

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 28

NPI Registry JSON

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

{
    "created_epoch": "1129766400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1762992000000",
    "number": "1114916293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1509 WILSON TER",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912064007",
            "telephone_number": "818-409-8000",
            "fax_number": "818-546-5600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1509 WILSON TER",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912064007",
            "telephone_number": "818-409-8000",
            "fax_number": "818-546-5600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GLENDALE ADVENTIST MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-20",
        "last_updated": "2025-11-13",
        "certification_date": "2025-11-13",
        "status": "A",
        "authorized_official_last_name": "ISSAI",
        "authorized_official_first_name": "ALICE",
        "authorized_official_title_or_position": "CEO/PRESIDENT",
        "authorized_official_telephone_number": "818-409-8289"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "CA",
            "license": "930000059",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "LTC55419F",
            "state": "CA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://esmd.officeally.io:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.2019.3",
            "affiliationName": "Bluemark LLC / Office Ally",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "1509 Wilson Ter",
            "city": "Glendale",
            "state": "CA",
            "country_code": "US",
            "postal_code": "912064007",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Adventist Health Glendale",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Glendale, CA

Sources for this page

Verify at the official NPI Registry.