NPIMap

Organization Active NPI

Cha Hollywood Medical Center LP

  • Skilled Nursing Facility
  • Los Angeles, CA
National Provider Identifier
1336164151
Registry record updated Apr 17, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
CHA HOLLYWOOD MEDICAL CENTER LP
Practice address
4636 Fountain Ave
Los Angeles, CA 90029-1830
Phone
(323) 913-4830
Fax
(323) 913-4552
NPI assigned
Jul 13, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 17, 2014

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

Authorized official

Name
Mr. Kenneth I Rivers
Title
President, Ceo
Phone
(323) 913-4914

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X Primary

Addresses

Primary practice location

4636 Fountain Ave
Los Angeles, CA 90029-1830

Mailing address

1300 N Vermont Ave
Los Angeles, CA 90027-6005
Phone (213) 413-3000

Other identifiers 2

IdentifierTypeStateIssuer
LTC70045GMedicaidCA
ZZT06311GMedicaidCA

Other names 1

  • Holyywood Presbyterian Medical Center Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20041207000776 CA Part A Provider - Skilled Nursing Facility 9032175476 Practice locations: Los Angeles, CA

Skilled nursing facility certification: CCN 056311

Legal name
CHA HOLLYWOOD MEDICAL CENTER LP
Doing business as
HOLLYWOOD PRESBYTERIAN MEDICAL CENTER
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Aug 3, 1971
Last certification
Dec 12, 2024
Beds
89
Ownership / control type
Corporation
Organization structure
PartnershipProprietary
Incorporated
in CA
Enrollment address
4636 Fountain Avenue
Los Angeles, CA 90029-1830
Nursing home name
HOLLYWOOD PRESBYTERIAN MEDICAL CENTER D/P SNF

Other NPIs with the same Medicare PAC ID 2

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Care Compare: Nursing home

Medicare Care Compare
Listed as
Hollywood Presbyterian Medical Center D/P SNFCCN 056311
Overall star rating
3 of 5
Health inspections
3 of 5
Staffing
3 of 5
Quality measures
4 of 5
Type
Medicare and Medicaid
Ownership
For profit - Corporation
Certified
Aug 3, 1971
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
8975.2 residents per day on average

Processed by Care Compare on Aug 1, 2026.

National Provider Directory

National Provider Directory
Tax ID family
Cha Hollywood Medical Center LP4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

Ownership & related parties

All disclosed owners & managing parties 4

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

NameRoleSinceShare
Marcel C Loh Individual Corporate OfficerHospital Ceo Oct 5, 2020 100%
W-2 Managing EmployeeCeo Oct 5, 2020 100%
Cha Health Systems Organization, Los Angeles, CA Created for acquisition, Corporation, For-profit Limited Partnership Interest Apr 2, 2001 98.75%
Won T Cha Individual Corporate OfficerCoo Oct 15, 2015
CHS Healthcare Management LLC Organization, Los Angeles, CA Created for acquisition, Corporation, LLC, For-profit General Partnership Interest Nov 29, 2005 1.25%

Practitioners & affiliated clinicians

Affiliated clinicians 2

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": "1152748800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1397692800000",
    "number": "1336164151",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1300 N VERMONT AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900276005",
            "telephone_number": "213-413-3000",
            "fax_number": "323-660-0446"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4636 FOUNTAIN AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900291830",
            "telephone_number": "323-913-4830",
            "fax_number": "323-913-4552"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHA HOLLYWOOD MEDICAL CENTER LP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-13",
        "last_updated": "2014-04-17",
        "status": "A",
        "authorized_official_last_name": "RIVERS",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_middle_name": "I",
        "authorized_official_title_or_position": "PRESIDENT, CEO",
        "authorized_official_telephone_number": "323-913-4914",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "LTC70045G",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ZZT06311G",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Holyywood Presbyterian Medical Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.