Active NPI
Temple Park Convalescent Hospital Inc.
- Skilled Nursing Facility
- Los Angeles, CA
National Provider Identifier
1295781896
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Skilled Nursing Facility
- License
- 970000074
- Legal business name
- TEMPLE PARK CONVALESCENT HOSPITAL INC.
- Practice address
- 2411 W Temple St
Los Angeles, CA 90026-4817 - Phone
- (213) 380-3210
- Fax
- (213) 382-0595
- NPI assigned
- May 25, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Veronica Dy
- Title
- Manager
- Phone
- (213) 487-3915
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | 970000074 | CA | Primary |
Addresses
Primary practice location
2411 W Temple St
Los Angeles, CA 90026-4817
Mailing address
2411 W Temple St
Los Angeles, CA 90026-4817
Phone (213) 380-3210
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| ZZT06181G | Medicaid | CA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20090129000224 | CA | Part A Provider - Skilled Nursing Facility | 8325102775 | Practice locations: Los Angeles, CA |
Skilled nursing facility certification: CCN 555019
- Legal name
- TEMPLE PARK CONVALESCENT HOSPITAL INC.
- Doing business as
- LTC ALLY
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF/NF dual certification
- Participating since
- Mar 11, 1976
- Last certification
- Apr 10, 2025
- Beds
- 99
- Ownership / control type
- Limited Liability Corporation
- Organization structure
- Corporation
- Incorporated
- Feb 26, 1976 in CA
- Enrollment address
- 2411 W Temple St
Los Angeles, CA 90026-4817 - Nursing home name
- TEMPLE PARK CONVALESCENT HOSPITAL
Care Compare: Nursing home
Medicare Care Compare- Listed as
- Temple Park Convalescent Hospital
- Overall star rating
- Health inspections
- Staffing
- Quality measures
- Type
- Medicare and Medicaid
- Ownership
- For profit - Limited Liability company
- Certified
- Mar 11, 1976
- Medicare certification status
- Active
- Certified beds
- 99
- Penalties (3 years)
- 2
National Provider Directory
National Provider DirectoryOwnership & related parties
All disclosed owners & managing parties 21
As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.
| Name | Role | Since | Share |
|---|---|---|---|
| Adp of the SNF | Jan 6, 2025 | ||
| Adp of the SNF | Feb 1, 1991 | ||
| Adp of the SNF | Sep 9, 2025 | ||
| Cecille Pardilla | Operational/Managerial Control | Jun 19, 2023 | |
| Adp of the SNF | Jun 19, 2023 | ||
| Renfel Cambare | Operational/Managerial Control | Jul 14, 2004 | |
| Adp of the SNF | Jul 15, 2004 | ||
| Adp of the SNF | Sep 9, 2025 | ||
| Lucia Zamora | Operational/Managerial Control | Jul 31, 2023 | |
| Adp of the SNF | Jul 31, 2023 | ||
| Harold Manansala | Operational/Managerial Control | Feb 3, 2025 | |
| Adp of the SNF | Feb 3, 2025 | ||
| Barry Kohn | 5% Or Greater Direct Ownership Interest | Feb 26, 1976 | 100% |
| Corporate Officer | Feb 26, 1976 | 100% | |
| Corporate Director | Feb 26, 1976 | 100% | |
| Operational/Managerial Control | Feb 26, 1976 | ||
| Adp of the SNF | Feb 26, 1976 | ||
| Elliot Zemel | Operational/Managerial Control | Nov 16, 2012 | |
| Adp of the SNF | Nov 16, 2012 | ||
| Adp of the SNF | Apr 1, 2024 | ||
| Adp of the SNF | Jan 10, 2015 | ||
| Adp of the SNF | Feb 1, 1991 | ||
| Adp of the SNF | Feb 1, 1991 | ||
| Adp of the SNF | Feb 1, 1991 | ||
| Adp of the SNF | Sep 9, 2025 | ||
| Toby Kohn | Corporate Officer | Feb 26, 1976 | |
| Corporate Director | Feb 26, 1976 | ||
| Operational/Managerial Control | Feb 26, 1976 | ||
| Adp of the SNF | Feb 26, 1976 | ||
| Eyal Shtorch | Operational/Managerial Control | Sep 5, 2025 | |
| Adp of the SNF | Sep 5, 2025 | ||
| Adp of the SNF | Jan 6, 2025 | ||
| Adp of the SNF | Feb 1, 1991 | ||
| Adp of the SNF | Sep 3, 2025 |
Owners & managing parties with NPI records 1
Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.
-
- Nephrology Physician
- Reseda, CA
- NPI 1942395603
Adp of the SNF, Operational/Managerial Control
Practitioners & affiliated clinicians
Affiliated clinicians 3
Clinicians who list this facility as an affiliation in Medicare Care Compare.
-
- Geriatric Medicine (Internal Medicine) Physician
- Los Angeles, CA
- NPI 1396775474
Nursing home
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1148515200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1554768000000",
"number": "1295781896",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2411 W TEMPLE ST",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900264817",
"telephone_number": "213-380-3210",
"fax_number": "213-382-0595"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2411 W TEMPLE ST",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900264817",
"telephone_number": "213-380-3210",
"fax_number": "213-382-0595"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "TEMPLE PARK CONVALESCENT HOSPITAL INC.",
"organizational_subpart": "NO",
"enumeration_date": "2006-05-25",
"last_updated": "2019-04-09",
"status": "A",
"authorized_official_last_name": "DY",
"authorized_official_first_name": "VERONICA",
"authorized_official_title_or_position": "MANAGER",
"authorized_official_telephone_number": "213-487-3915"
},
"taxonomies": [
{
"code": "314000000X",
"taxonomy_group": "",
"desc": "Skilled Nursing Facility",
"state": "CA",
"license": "970000074",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "ZZT06181G",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Los Angeles, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2019; 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.