NPIMap

Organization Active NPI

Asian Pacific Health Care Venture, Inc.

  • Community Health Clinic/Center
  • Los Angeles, CA
National Provider Identifier
1336208255
Registry record updated May 7, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Health Clinic/CenterTaxonomy code 261QC1500X
License
960001028 Issued in CA
Legal business name
ASIAN PACIFIC HEALTH CARE VENTURE, INC.
Practice address
1530 Hillhurst Ave
Los Angeles, CA 90027-5516
Phone
(323) 644-3880
Fax
(323) 644-3892
NPI assigned
Dec 6, 2006
Last updated
May 7, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 7, 2008

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

Authorized official

Name
Kazue Shibata
Title
Chief Executive Officer
Phone
(323) 644-3880

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health Clinic/Center 261QC1500X 960001028 CA Primary

Addresses

Primary practice location

1530 Hillhurst Ave
Los Angeles, CA 90027-5516

Mailing address

1530 Hillhurst Ave
Los Angeles, CA 90027-5516
Phone (323) 644-3880

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20030219000001 CA Part A Provider - Federally Qualified Health Center (FQHC) 8729997390 Practice locations: Los Angeles, CA
O20050429000995 CA Part B Supplier - Clinic/Group Practice 8729997390 Receives reassigned benefits from 56 practitioners
1 other NPI on this enrollment
Practice locations: El Monte, CA; Los Angeles, CA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1336208255. Details of each certification follow.

Federally qualified health center certification: CCN 551927

Legal name
ASIAN PACIFIC HEALTH CARE VENTURE, INC.
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Jun 10, 2003
Last certification
Jun 10, 2003
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Oct 7, 1987 in CA
Enrollment address
1530 Hillhurst Ave
Los Angeles, CA 90027-5516

Other NPIs with the same Medicare PAC ID 2

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

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Networks

  • BSC 65 PLUS INDIVIDUAL MAPDPlans: Blue Shield 65 Plus (HMO) (H0504-015-000, H0504); Blue Shield 65 Plus (HMO) (H0504-039-000, H0504); Blue Shield 65 Plus Plan 2 (HMO) (H0504-021-000, H0504); Blue Shield Inspire (HMO) (H0504-041-000, H0504); Blue Shield 65 Plus (HMO) (H0504-038-000, H0504); Blue Shield Inspire (HMO) (H0504-047-000, H0504); Blue Shield 65 Plus (HMO) (H0504-026-000, H0504); Blue Shield Advantage (HMO) (H0504-050-000, H0504); Blue Shield AdvantageOptimum Plan (HMO) (H5928-004-000, H5928); Blue Shield Inspire (HMO) (H0504-043-000, H0504)…

Ownership & related parties

All disclosed owners & managing parties 9

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

NameRoleSinceShare
Michael a Epstein Individual Corporate OfficerBoard Vice President Oct 26, 2015
Corporate DirectorBoard Member Jan 26, 2015
Nardo B Beltran Individual Corporate OfficerCfo Oct 6, 2003
W-2 Managing EmployeeCfo Oct 1, 2001
Samy L Sadighi Individual Corporate OfficerBoard Secretary Jan 22, 2018
Corporate DirectorBoard Member Oct 23, 2017
Joselito G Turdanes Individual Corporate OfficerBoard Treasurer Oct 23, 2017
Corporate DirectorBoard Member Jan 26, 2015
Kathy W Holliday Individual Corporate DirectorBoard Member Nov 28, 2016
Kazue Shibata Individual Corporate OfficerCeo Oct 6, 2003
W-2 Managing EmployeeCeo Apr 11, 1991
Nittaya Pichedvanichok Individual Corporate DirectorBoard Member Aug 8, 2011
Catherine Bess a Sunga Individual Corporate DirectorBoard Member Nov 28, 2016
Dean C Norman Individual Corporate OfficerBoard President Aug 13, 2012
Corporate DirectorBoard Member Sep 12, 2011

Practitioners & affiliated clinicians

Practitioners 58

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 58

NPI Registry JSON

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

{
    "created_epoch": "1165363200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1210118400000",
    "number": "1336208255",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1530 HILLHURST AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900275516",
            "telephone_number": "323-644-3880",
            "fax_number": "323-644-3892"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1530 HILLHURST AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900275516",
            "telephone_number": "323-644-3880",
            "fax_number": "323-644-3892"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ASIAN PACIFIC HEALTH CARE VENTURE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-06",
        "last_updated": "2008-05-07",
        "status": "A",
        "authorized_official_last_name": "SHIBATA",
        "authorized_official_first_name": "KAZUE",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "323-644-3880"
    },
    "taxonomies": [
        {
            "code": "261QC1500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Community Health",
            "state": "CA",
            "license": "960001028",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.