Organization Active NPI

Temple Park Convalescent Hospital Inc.

  • Skilled Nursing Facility
  • Los Angeles, CA
National Provider Identifier
1295781896
Registry record updated Apr 9, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
970000074 Issued in CA
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

Updated by the provider on Apr 9, 2019

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)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
ZZT06181GMedicaidCA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
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
CorporationProprietary
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 HospitalCCN 555019
Overall star rating
1 of 5
Health inspections
2 of 5
Staffing
4 of 5
Quality measures
1 of 5
Type
Medicare and Medicaid
Ownership
For profit - Limited Liability company
Certified
Mar 11, 1976
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
9994.4 residents per day on average
Penalties (3 years)
2Fines totaling $144,964

Processed by Care Compare on Aug 1, 2026.

National Provider Directory

National Provider Directory

Ownership & 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.

NameRoleSinceShare
Organization, Los Angeles, CA Adp of the SNF Jan 6, 2025
Individual Adp of the SNF Feb 1, 1991
Organization, West Covina, CA Corporation, Medical provider/supplier, For-profit Adp of the SNF Sep 9, 2025
Cecille Pardilla Individual Operational/Managerial Control Jun 19, 2023
Adp of the SNF Jun 19, 2023
Renfel Cambare Individual Operational/Managerial Control Jul 14, 2004
Adp of the SNF Jul 15, 2004
Organization, Northridge, CA Corporation, Medical provider/supplier, For-profit Adp of the SNF Sep 9, 2025
Lucia Zamora Individual Operational/Managerial Control Jul 31, 2023
Adp of the SNF Jul 31, 2023
Harold Manansala Individual Operational/Managerial Control Feb 3, 2025
Adp of the SNF Feb 3, 2025
Barry Kohn Individual 5% Or Greater Direct Ownership InterestPresident Feb 26, 1976 100%
Corporate OfficerPresident Feb 26, 1976 100%
Corporate DirectorPresident Feb 26, 1976 100%
Operational/Managerial Control Feb 26, 1976
Adp of the SNF Feb 26, 1976
Elliot Zemel Individual Operational/Managerial Control Nov 16, 2012
Adp of the SNF Nov 16, 2012
Individual Adp of the SNF Apr 1, 2024
Individual Adp of the SNF Jan 10, 2015
Organization, Los Angeles, CA LLC, For-profit Adp of the SNF Feb 1, 1991
Organization, Culver City, CA For-profit Adp of the SNF Feb 1, 1991
Individual Adp of the SNF Feb 1, 1991
Organization, Conroe, TX LLC, Consulting firm, For-profit Adp of the SNF Sep 9, 2025
Toby Kohn Individual Corporate OfficerSecretary/Controller Feb 26, 1976
Corporate DirectorSecretary/Controller Feb 26, 1976
Operational/Managerial Control Feb 26, 1976
Adp of the SNF Feb 26, 1976
Eyal Shtorch Individual Operational/Managerial Control Sep 5, 2025
Adp of the SNF Sep 5, 2025
Organization, Los Angeles, CA Adp of the SNF Jan 6, 2025
Individual Adp of the SNF Feb 1, 1991
Organization, Portland, OR LLC, Consulting firm, For-profit 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.

Practitioners & affiliated clinicians

Affiliated clinicians 3

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": "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

Verify at the official NPI Registry.