NPIMap

Organization Active NPI

Prime Healthcare la Palma LLC

Doing business as La Palma Intercommunity Hospital

  • Psychiatric Hospital Unit
  • La Palma, CA
National Provider Identifier
1386947836
Registry record updated Mar 12, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric Hospital UnitTaxonomy code 273R00000X
Legal business name
PRIME HEALTHCARE LA PALMA LLC
Doing business as
La Palma Intercommunity Hospital
Practice address
7901 Walker St
La Palma, CA 90623-1722
Phone
(714) 670-7400
NPI assigned
Dec 6, 2010
Last updated
Mar 12, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 12, 2014

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

Authorized official

Name
Troy A. Schell
Title
Secretary / General Counsel
Phone
(909) 235-4311

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric Hospital Unit 273R00000X NU Primary

Addresses

Primary practice location

7901 Walker St
La Palma, CA 90623-1722

Mailing address

7901 Walker St
La Palma, CA 90623-1722
Phone (714) 670-7400

Other names 1

  • La Palma Intercommunity Hospital Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070626000681 CA Part A Provider - Hospital 1153326228 1 other NPI on this enrollment
Practice locations: La Palma, CA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1386947836. Details of each certification follow.

Hospital certification: CCN 05S580

Legal name
PRIME HEALTHCARE LA PALMA LLC
Doing business as
LA PALMA INTERCOMMUNITY HOSPITAL
Organization structure
LLCNon-profit
Incorporated
Jul 21, 2006 in DE
Enrollment address
7901 Walker St
La Palma, CA 90623-1722
Hospital Psychiatric Unit
Hospital subgroups
Psychiatric unit

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

Other NPIs with the same Medicare PAC ID 1

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

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Ownership & related parties

All disclosed owners & managing parties 6

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 Other Oct 1, 2006
Ayman Mousa Individual Corporate OfficerChief Executive Officer Jul 1, 2021
Corporate DirectorDirector Jul 1, 2021
W-2 Managing EmployeeChief Executive Officer Jul 1, 2021
Steven Aleman Individual OtherChief Financial Officer Jun 1, 2020
Christopher Doan Individual Corporate OfficerManaging Associate General Counsel Jun 1, 2020
Prime Healthcare Foundation Inc Organization, Ontario, CA Corporation, Non-profit 5% Or Greater Direct Ownership Interest Dec 31, 2014 100%
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 82

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

View all 82

NPI Registry JSON

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

{
    "created_epoch": "1291593600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1394582400000",
    "number": "1386947836",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7901 WALKER ST",
            "city": "LA PALMA",
            "state": "CA",
            "postal_code": "906231722",
            "telephone_number": "714-670-7400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7901 WALKER ST",
            "city": "LA PALMA",
            "state": "CA",
            "postal_code": "906231722",
            "telephone_number": "714-670-7400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIME HEALTHCARE LA PALMA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-12-06",
        "last_updated": "2014-03-12",
        "status": "A",
        "authorized_official_last_name": "SCHELL",
        "authorized_official_first_name": "TROY",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "SECRETARY / GENERAL COUNSEL",
        "authorized_official_telephone_number": "909-235-4311"
    },
    "taxonomies": [
        {
            "code": "273R00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Unit",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "La Palma Intercommunity Hospital",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in La Palma, CA

Sources for this page

Verify at the official NPI Registry.