NPIMap

Organization Active NPI

Prime Healthcare Paradise Valley LLC

Doing business as Paradise Valley Hospital

  • General Acute Care Hospital
  • National City, CA
National Provider Identifier
1356410351
Registry record updated Apr 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Acute Care HospitalTaxonomy code 282N00000X
License
090000086 Issued in CA
Legal business name
PRIME HEALTHCARE PARADISE VALLEY LLC
Doing business as
Paradise Valley Hospital
Practice address
2400 E 4TH St
National City, CA 91950-2026
Phone
(619) 470-4321
NPI assigned
Nov 6, 2006
Last updated
Apr 14, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 14, 2023

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

Authorized official

Name
Christopher Doan
Title
Managing Associate General Counsel
Phone
(310) 259-4706

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Acute Care Hospital 282N00000X 090000086 CA Primary

Addresses

Primary practice location

2400 E 4TH St
National City, CA 91950-2026

Mailing address

3480 E Guasti Rd
Ontario, CA 91761-7684
Phone (909) 235-4400

Other names 1

  • Paradise Valley Hospital Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20061227000375 CA Part A Provider - Hospital 4587664412 1 other NPI on this enrollment
Practice locations: National City, CA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1356410351. Details of each certification follow.

Hospital certification: CCN 050024

Legal name
PRIME HEALTHCARE PARADISE VALLEY LLC
Doing business as
PARADISE VALLEY HOSPITAL
Certification status
Active
Provider type (POS)
Hospital – Short-term
Participating since
Jul 1, 1966
Last certification
Mar 29, 2019
Beds
237
Ownership / control type
Private (for profit)
Organization structure
LLCProprietary
Incorporated
Nov 6, 2006 in DE
Enrollment address
2400 E 4TH St
National City, CA 91950-2026
Main/Primary Hospital Location
Hospital subgroups
Acute care, Rehabilitation

Facilities connected through Provider of Services related, parent or unit certification numbers.

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.

Care Compare: Hospital

Medicare Care Compare
Listed as
Paradise Valley HospitalCCN 050024 · All quality measures
Overall star rating
3 of 5
Type
Acute Care Hospitals
Ownership
Proprietary
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 8

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

NameRoleSinceShare
Prime Healthcare Services, Inc Organization, Ontario, CA Corporation 5% Or Greater Direct Ownership Interest Mar 1, 2007 100%
Other Mar 1, 2007 100%
Gemma Rama B Individual Corporate DirectorBoard Member Jan 1, 2013
OtherBoard Member Jan 1, 2013
Luis Leon Individual Corporate OfficerCorporate Chief Executive Officer Mar 4, 2012
Prakash K Bhatia Individual Corporate DirectorBoard Member Jan 1, 2013
OtherGoverning Board Jan 1, 2013
Neerav Jadeja Individual Corporate OfficerChief Executive Officer Jun 1, 2019
Corporate DirectorBoard Member Jan 1, 2013
W-2 Managing EmployeeChief Executive Officer Jun 1, 2019
Steven Aleman Individual Corporate OfficerChief Financial Officer Jun 1, 2020
Christopher Doan Individual Corporate OfficerChief Compliance Counsel Apr 24, 2017
Prime Healthcare Holdings Inc Organization, Ontario, CA Corporation, Holding company 5% Or Greater Indirect Ownership Interest Apr 21, 2010 100%

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Facilities with the same owner 77

Facilities that share an organizational owner with 5% or greater ownership or operational control.

View all 77

Practitioners & affiliated clinicians

Affiliated clinicians 93

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 93

NPI Registry JSON

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

{
    "created_epoch": "1162771200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1681430400000",
    "number": "1356410351",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3480 E GUASTI RD",
            "city": "ONTARIO",
            "state": "CA",
            "postal_code": "917617684",
            "telephone_number": "909-235-4400",
            "fax_number": "909-235-4316"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2400 E 4TH ST",
            "city": "NATIONAL CITY",
            "state": "CA",
            "postal_code": "919502026",
            "telephone_number": "619-470-4321"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIME HEALTHCARE PARADISE VALLEY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-06",
        "last_updated": "2023-04-14",
        "certification_date": "2023-04-14",
        "status": "A",
        "authorized_official_last_name": "DOAN",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_title_or_position": "MANAGING ASSOCIATE GENERAL COUNSEL",
        "authorized_official_telephone_number": "310-259-4706"
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "CA",
            "license": "090000086",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Paradise Valley Hospital",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Paradise Valley Hospital",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in National City, CA

Sources for this page

Verify at the official NPI Registry.