Alakor Healthcare LLC
Organization Active NPI Long Term Care Hospital · Monrovia, CA
NPI 1265601561 · NPPES record last updated Jun 23, 2009
Key facts
- NPI
- 1265601561
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Long Term Care Hospital 282E00000X
- License
- 930000107 (CA)
- Legal business name
- ALAKOR HEALTHCARE LLC
- Practice address
- 323 S Heliotrope Ave
Monrovia, CA 91016-2914 - Phone
- (626) 408-9800
- Fax
- (626) 408-9809
- NPI assigned
- Feb 21, 2008
- Organization subpart
- No
Authorized official
- Name
- Mr. Ron Kupferstein
- Title
- Chief Executive Officer
- Phone
- (626) 408-9800
Affiliated clinicians 12
-
Jilin Bai, M.D.
-
Donald Balacuit, DO
-
Jason K Boutros, M.D.
-
Vishal Govil, D.O.
-
David Y Lin, DO
-
Ngo C. Phan, M.D.
-
Kevin Tai, DO
-
Sherry Xie, M.D.
-
Jun Xu, M.D.
Medicare Care Compare: Long-term care hospital
- Listed as
- Monrovia Memorial Hospital
- Ownership
- For profit
- Certified
- May 1, 2009
- Medicare certification status
- Active
- Beds
- 49
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 05D1079813 | Alakor Healthcare, LLC | Accreditation | Feb 26, 2028 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
Hospital certification: CCN 052054
- Legal name
- ALAKOR HEALTHCARE LLC
- Doing business as
- MONROVIA MEMORIAL HOSPITAL
- Certification status
- Active
- Provider type (POS)
- Hospital – Long-term
- Participating since
- May 1, 2009
- Last certification
- Jul 18, 2023
- Beds
- 49
- Ownership / control type
- Private (for profit)
- Organization structure
- LLC · Proprietary
- Incorporated
- Aug 25, 2007 in CA
- Enrollment address
- 323 S Heliotrope Ave
Monrovia, CA 91016-2914 - Hospital subgroups
- General, Acute care
All disclosed owners & managing parties 4
| Name | Role | Since | Share |
|---|---|---|---|
| Alakor Healthcare LLC |
5% Or Greater Direct Ownership Interest | Oct 3, 2008 | 100% |
| Ronald Kupferstein |
5% Or Greater Indirect Ownership Interest | Sep 30, 2022 | 17.6% |
| Corporate Officer |
Sep 30, 2022 | 17.6% | |
| Corporate Director |
Jul 7, 2007 | 15% | |
| W-2 Managing Employee |
Jul 7, 2007 | 15% | |
| Kevin Smith |
5% Or Greater Indirect Ownership Interest | Sep 30, 2022 | 70.6% |
| Corporate Officer |
Jul 7, 2007 | 70.6% | |
| Corporate Director | Jul 7, 2007 | 60% | |
| Lawrence J Domaracki |
5% Or Greater Indirect Ownership Interest | Sep 30, 2022 | 11.8% |
| Corporate Officer |
Jul 7, 2007 | 10% | |
| Corporate Director | Jul 7, 2007 | 10% |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20090618000708 | CA | Part a Provider - Hospital | 0648355891 | Practice locations: Monrovia, CA |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Long Term Care Hospital | 282E00000X | 930000107 | CA | Yes |
Addresses
Primary practice location
323 S Heliotrope Ave
Monrovia, CA 91016-2914
Mailing address
323 S Heliotrope Ave
Monrovia, CA 91016-2914
Phone (626) 408-9800
Other names
- Monrovia Memorial Hospital
Other providers in Monrovia, CA
- Malik Al-Shabazz
- Amna Alaalgawi
- Olufunke Folasade Alade-Chester
- Merari Alago-Sanford
- Kris Alair
- Mahmoud Alamad
- Hafsah Alamgir
- Niaysha Alamo
- Shante Alamo
- Alana Holland Therapy Inc
All providers in Monrovia, CA · Long Term Care Hospital in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 23, 2009. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.