College Vista, LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

970000044 Issued in CA

Legal business name

COLLEGE VISTA, LLC

Practice address

4681 North Eagle Rock Blvd
Los Angeles, CA 90041

Phone

(323) 257-8151

Fax

(323) 257-2187

NPI assigned

Oct 2, 2015

Organization subpart

No

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

Authorized official

Name

Adrian Dehghanmanesh

Title

Cfo

Phone

(714) 577-3880

Specialties & licenses 1

Addresses

Other names 2

• College Vista Convalescent Hospital Doing business as
• College Vista Post-Acute Doing business as

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Skilled nursing facility certification: CCN 555030

Legal name

COLLEGE VISTA LLC

Doing business as

COLLEGE VISTA POST-ACUTE

Certification status

Active

Provider type (POS)

Nursing home – SNF/NF dual certification

Participating since

Jul 2, 1976

Last certification

May 9, 2025

Beds

49

Ownership / control type

Corporation

Multi-facility organization

SUN MAR HEALTHCARE

Organization structure

LLCProprietary

Incorporated

Jul 9, 2015 in CA

Enrollment address

4681 Eagle Rock Blvd
Los Angeles, CA 90041-3036

Nursing home name

COLLEGE VISTA POST-ACUTE

Affiliated entity

DAVID JOHNSON

Listed as

College Vista Post-AcuteCCN 555030

Overall star rating

2 of 5

Health inspections

2 of 5

Staffing

3 of 5

Quality measures

4 of 5

Type

Medicare and Medicaid

Ownership

For profit - Corporation

Certified

Jul 2, 1976

Medicare certification status

ActiveFrom the Provider of Services file

Certified beds

4942.4 residents per day on average

Chain

David Johnson48 facilities in the chain

Penalties (3 years)

2Fines totaling $43,568

Processed by Care Compare on Aug 1, 2026.

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

CLIA laboratory certificates

All disclosed owners & managing parties 15

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

Owners & managing parties with NPI records 2

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

• Pablo Javier Bassuk, M.D.

  • Family Medicine Physician
  • Glendale, CA
  • NPI 1972625069

  Adp of the SNF, Operational/Managerial Control

  CMS ownership
• Eli E Marmur, M.A., R.P.T.

  • Physical Therapist
  • Los Angeles, CA
  • NPI 1720199664

  5% Or Greater Indirect Ownership Interest

  CMS ownership

Affiliated clinicians 2

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

• Pablo Javier Bassuk, M.D.

  • Family Medicine Physician
  • Glendale, CA
  • NPI 1972625069

  Nursing home

  Care Compare affiliation
• John K Liu, MD

  • Physical Medicine & Rehabilitation Physician
  • Huntington Park, CA
  • NPI 1194739797

  Nursing home

  Care Compare affiliation

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

{
    "created_epoch": "1443744000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1774224000000",
    "number": "1194195164",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3050 SATURN ST STE 201",
            "city": "BREA",
            "state": "CA",
            "postal_code": "928216278",
            "telephone_number": "714-577-3880",
            "fax_number": "714-577-3895"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4681 NORTH EAGLE ROCK BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "90041",
            "telephone_number": "323-257-8151",
            "fax_number": "323-257-2187"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLLEGE VISTA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-10-02",
        "last_updated": "2026-03-23",
        "certification_date": "2026-03-23",
        "status": "A",
        "authorized_official_last_name": "DEHGHANMANESH",
        "authorized_official_first_name": "ADRIAN",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "714-577-3880"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "CA",
            "license": "970000044",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "College Vista Convalescent Hospital",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "College Vista Post-Acute",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Edith Collazo
• Jean Socorro Collazo, D.C.
• Silvia Collazo, DO
• Stephani Collazo
• Alberto Collazzoni
• Casey Ann Collet, MD
• Patrick Michael Colletti, M.D.
• Lashasta Monik Colley
• Claire Christine Collier, RN
• Elizabeth Collier

• Skilled Nursing Facility in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Skilled Nursing Facility in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• 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.