Active NPI
P & J Hospital, Inc.
- Skilled Nursing Facility
- Bell, CA
National Provider Identifier
1376575449
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Skilled Nursing Facility
- License
- 940000014
- Legal business name
- P & J HOSPITAL, INC.
- Practice address
- 4900 Florence Ave
Bell, CA 90201-4319 - Phone
- (323) 560-2045
- Fax
- (323) 560-0182
- NPI assigned
- Jul 7, 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
- Jin Y. Park
- Title
- President
- Phone
- (323) 560-2045
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | 940000014 | CA | Primary |
Addresses
Primary practice location
4900 Florence Ave
Bell, CA 90201-4319
Mailing address
4900 Florence Ave
Bell, CA 90201-4319
Phone (323) 560-2045
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 940000014 | Other | CA | STATE LICENSE |
| ZZT06218I | Medicaid | CA |
Other names 1
- Bell Convalescent Hospital
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20060425000769 | CA | Part A Provider - Skilled Nursing Facility | 7416967104 | Practice locations: Bell, CA |
Skilled nursing facility certification: CCN 056218
- Legal name
- P & J HOSPITAL, INC.
- Doing business as
- BELL CONVALESCENT HOSPITAL
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF/NF dual certification
- Participating since
- Feb 25, 1970
- Last certification
- Dec 5, 2024
- Beds
- 99
- Ownership / control type
- Corporation
- Organization structure
- Corporation
- Incorporated
- Aug 15, 2005 in CA
- Enrollment address
- 4900 Florence Ave
Bell, CA 90201-4319 - Nursing home name
- BELL CONVALESCENT HOSPITAL
Care Compare: Nursing home
Medicare Care Compare- Listed as
- Bell Convalescent Hospital
- Overall star rating
- Health inspections
- Staffing
- Quality measures
- Type
- Medicare and Medicaid
- Ownership
- For profit - Corporation
- Certified
- Feb 25, 1970
- Medicare certification status
- Active
- Certified beds
- 99
- Penalties (3 years)
- 4
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 05D0726083 | Bell Convalescent Hospital | Certificate of waiver | Aug 27, 2026 |
National Provider Directory
National Provider DirectoryOwnership & related parties
All disclosed owners & managing parties 3
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 | Nov 27, 2024 | ||
| Timothy C Park | W-2 Managing Employee | Apr 1, 2010 | |
| Jin Yeong Park | 5% Or Greater Direct Ownership Interest | Aug 15, 2005 | |
| Corporate Director | Apr 25, 2006 |
Practitioners & affiliated clinicians
Affiliated clinicians 2
Clinicians who list this facility as an affiliation in Medicare Care Compare.
-
- Cardiovascular Disease Physician
- Huntington Park, CA
- NPI 1720005259
Nursing home
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152230400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1213142400000",
"number": "1376575449",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4900 FLORENCE AVE",
"city": "BELL",
"state": "CA",
"postal_code": "902014319",
"telephone_number": "323-560-2045",
"fax_number": "323-560-0182"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4900 FLORENCE AVE",
"city": "BELL",
"state": "CA",
"postal_code": "902014319",
"telephone_number": "323-560-2045",
"fax_number": "323-560-0182"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "P & J HOSPITAL, INC.",
"organizational_subpart": "NO",
"enumeration_date": "2006-07-07",
"last_updated": "2008-06-11",
"status": "A",
"authorized_official_last_name": "PARK",
"authorized_official_first_name": "JIN",
"authorized_official_middle_name": "Y.",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "323-560-2045"
},
"taxonomies": [
{
"code": "314000000X",
"taxonomy_group": "",
"desc": "Skilled Nursing Facility",
"state": "CA",
"license": "940000014",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE LICENSE",
"identifier": "940000014",
"state": "CA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "ZZT06218I",
"state": "CA"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Bell Convalescent Hospital",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Bell, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2008; 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.