NPIMap

Organization Active NPI

Mid-Wilshire Health Care Center

Doing business as Fidelity Health Care

  • Skilled Nursing Facility
  • El Monte, CA
National Provider Identifier
1194898205
Registry record updated Jan 5, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
MID-WILSHIRE HEALTH CARE CENTER
Doing business as
Fidelity Health Care
Fidelity Health Care & Rehab
Practice address
11210 Lower Azusa Rd
El Monte, CA 91731-1412
Phone
(626) 442-6863
Fax
(626) 350-3006
NPI assigned
Nov 16, 2006
Last updated
Jan 5, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 5, 2026

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

Authorized official

Name
Ms. Joan Lee
Title
Ceo/President
Phone
(323) 935-8490

Specialties & licenses 1

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

Addresses

Primary practice location

11210 Lower Azusa Rd
El Monte, CA 91731-1412

Mailing address

1101 Crenshaw Blvd
Los Angeles, CA 90019-3112
Phone (323) 934-5660

Other identifiers 1

IdentifierTypeStateIssuer
ZZT06191KMedicaidCA

Other names 2

  • Fidelity Health Care Doing business as
  • Fidelity Health Care & Rehab Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20091029000529 CA Part A Provider - Skilled Nursing Facility 2769567452 Practice locations: El Monte, CA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1194898205. Details of each certification follow.

Skilled nursing facility certification: CCN 555088

Legal name
MID-WILSHIRE HEALTH CARE CENTER
Doing business as
FIDELITY HEALTH CARE & REHAB
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
May 4, 1978
Last certification
Apr 4, 2025
Beds
90
Ownership / control type
Limited Liability Corporation
Organization structure
CorporationProprietary
Incorporated
Mar 16, 2001 in CA
Enrollment address
11210 Lower Azusa Rd
El Monte, CA 91731-1412
Nursing home name
FIDELITY HEALTH CARE
Affiliated entity
IL & JOAN LEE

Care Compare: Nursing home

Medicare Care Compare
Listed as
Fidelity Health CareCCN 555088 · All quality measures
Overall star rating
3 of 5
Health inspections
2 of 5
Staffing
5 of 5
Quality measures
4 of 5
Type
Medicare and Medicaid
Ownership
For profit - Corporation
Certified
May 4, 1978
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
9077.0 residents per day on average
Chain
Il & Joan Lee4 facilities in the chain
Abuse citation
Cited for abuse (Care Compare abuse icon)

Processed by Care Compare on Aug 1, 2026.

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
05D0699589Fidelity Health Care and Rehab11210 Lower Azusa Rd, El Monte, CA 91731Certificate of waiverAug 31, 2026

National Provider Directory

National Provider Directory
Tax ID family
Fidelity Health Care2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

Ownership & related parties

All disclosed owners & managing parties 5

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

NameRoleSinceShare
JPH Consulting Inc Organization, Los Angeles, CA Corporation, Consulting firm, For-profit Operational/Managerial Control Jan 1, 1997
Adp of the SNF Jan 20, 2025
Alex a Chua Individual Operational/Managerial Control Jun 1, 2019
Adp of the SNF Jun 1, 2019
Joan H Lee Individual 5% Or Greater Direct Ownership InterestCeo/President Mar 16, 2001 51%
Corporate OfficerCeo/President Mar 1, 2001 51%
Operational/Managerial Control Mar 16, 2001
Managing Control - Governing BodyCeo/President Mar 1, 2001
Direct Ownership Interest Mar 16, 2001 51%
Anil Gupta Individual Operational/Managerial Control Jan 1, 2014
Adp of the SNF Jan 1, 2014
Il Lee Individual 5% Or Greater Direct Ownership InterestSecretary Mar 16, 2001 49%
Corporate OfficerSecretary Mar 16, 2001 49%
Operational/Managerial Control Mar 16, 2001
Managing Control - Governing BodySecretary Mar 16, 2001
Direct Ownership Interest Mar 16, 2001 49%

Owners & managing parties with NPI records 1

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

  • Anil Gupta, MD
    • Internal Medicine Physician
    • West Covina, CA
    • NPI 1538182407

    Adp of the SNF, Operational/Managerial Control

    CMS ownership

Facilities with the same owner 1

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

Practitioners & affiliated clinicians

Affiliated clinicians 4

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

NPI Registry JSON

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

{
    "created_epoch": "1163635200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1767571200000",
    "number": "1194898205",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1101 CRENSHAW BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900193112",
            "telephone_number": "323-934-5660",
            "fax_number": "323-934-0852"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11210 LOWER AZUSA RD",
            "city": "EL MONTE",
            "state": "CA",
            "postal_code": "917311412",
            "telephone_number": "626-442-6863",
            "fax_number": "626-350-3006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MID-WILSHIRE HEALTH CARE CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-16",
        "last_updated": "2026-01-05",
        "certification_date": "2026-01-05",
        "status": "A",
        "authorized_official_last_name": "LEE",
        "authorized_official_first_name": "JOAN",
        "authorized_official_title_or_position": "CEO/PRESIDENT",
        "authorized_official_telephone_number": "323-935-8490",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ZZT06191K",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Fidelity Health Care",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Fidelity Health Care & Rehab",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in El Monte, CA

Sources for this page

Verify at the official NPI Registry.