8520 Western Avenue Inc

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

060000106 Issued in CA

Legal business name

8520 WESTERN AVENUE INC

Doing business as

Buena Park Nursing Center

Practice address

8520 Western Ave
Buena Park, CA 90620-3927

Phone

(714) 828-8222

Fax

(714) 828-1467

NPI assigned

Sep 28, 2005

Organization subpart

No

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

Authorized official

Name

Mr. John Henry Sy

Title

VP of Revenue Management

Phone

(562) 930-0777

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• BUENA PARK NURSING CENTER Doing business as

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1497742167. Details of each certification follow.

• CCN 055571 Skilled nursing facility · Active · Details

Skilled nursing facility certification: CCN 055571

Legal name

8520 WESTERN AVENUE INC

Doing business as

BUENA PARK NURSING CENTER

Certification status

Active

Provider type (POS)

Nursing home – SNF/NF dual certification

Participating since

Apr 1, 1977

Last certification

Nov 21, 2024

Beds

143

Ownership / control type

Corporation

Organization structure

CorporationProprietary

Incorporated

Dec 22, 1988 in CA

Enrollment address

8520 Western Ave
Buena Park, CA 90620-3927

Nursing home name

BUENA PARK NURSING CENTER

Affiliated entity

THE MANDELBAUM FAMILY

Listed as

Buena Park Nursing CenterCCN 055571 · All quality measures

Overall star rating

2 of 5

Health inspections

1 of 5

Staffing

4 of 5

Quality measures

5 of 5

Type

Medicare and Medicaid

Ownership

For profit - Corporation

Certified

Apr 1, 1977

Medicare certification status

ActiveFrom the Provider of Services file

Certified beds

143126.6 residents per day on average

Chain

The Mandelbaum Family18 facilities in the chain

Penalties (3 years)

2Fines totaling $8,278

Processed by Care Compare on Aug 1, 2026.

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

All disclosed owners & managing parties 15

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

Owners & managing parties with NPI records 1

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

• Fariborz Shams, D.O.

  • Internal Medicine Physician
  • Anaheim, CA
  • NPI 1063421865

  Adp of the SNF, Operational/Managerial Control

  CMS ownership

Facilities with the same owner 16

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

• 1130 W la Palma Ave Inc

  dba La Palma Nursing Center

  • Skilled Nursing Facility
  • Anaheim, CA
  • NPI 1881681559

  The Bentzion Mandelbaum 2021 Irrevocable Gift Trust No. 2, The Janet Mandelbaum 2021 Irrevocable Gift Trust No 2, The Simcha Mandelbaum 2021 Irrevocable Gift Trust No. 2

  CMS ownership
• 1135 N Leisure CT Inc

  dba Leisure Court Nursing Center

  • Skilled Nursing Facility
  • Anaheim, CA
  • NPI 1033106703

  The Bentzion Mandelbaum 2021 Irrevocable Gift Trust No. 2, The Janet Mandelbaum 2021 Irrevocable Gift Trust No 2, The Simcha Mandelbaum 2021 Irrevocable Gift Trust No. 2

  CMS ownership
• 12232 Chapman Ave Inc

  dba Chapman Care Center

  • Skilled Nursing Facility
  • Garden Grove, CA
  • NPI 1437146032

  The Bentzion Mandelbaum 2021 Irrevocable Gift Trust No. 2, The Janet Mandelbaum 2021 Irrevocable Gift Trust No 2, The Simcha Mandelbaum 2021 Irrevocable Gift Trust No. 2

  CMS ownership
• 533 South Fairfax Avenue Inc

  dba Guardian Rehabilitation Hospital

  • Skilled Nursing Facility
  • Los Angeles, CA
  • NPI 1639166242

  The Bentzion Mandelbaum 2021 Irrevocable Gift Trust No. 2, The Janet Mandelbaum 2021 Irrevocable Gift Trust No 2, The Simcha Mandelbaum 2021 Irrevocable Gift Trust No. 2

  CMS ownership
• Bellflower Post Acute LLC

  dba Bellflower Post Acute

  • Skilled Nursing Facility
  • Bellflower, CA
  • NPI 1154791895

  The Bentzion Mandelbaum 2021 Irrevocable Gift Trust No. 2, The Janet Mandelbaum 2021 Irrevocable Gift Trust No 2, The Simcha Mandelbaum 2021 Irrevocable Gift Trust No. 2

  CMS ownership
• Coastal View Healthcare Center LLC

  dba Coastal View Healthcare Center

  • Skilled Nursing Facility
  • Ventura, CA
  • NPI 1497011282

  The Bentzion Mandelbaum 2021 Irrevocable Gift Trust No. 2, The Janet Mandelbaum 2021 Irrevocable Gift Trust No 2, The Simcha Mandelbaum 2021 Irrevocable Gift Trust No. 2

  CMS ownership
• Community Convalescent Center of Montclair Inc

  dba Community Extended Care Hospital

  • Skilled Nursing Facility
  • Montclair, CA
  • NPI 1851388458

  The Bentzion Mandelbaum 2021 Irrevocable Gift Trust No. 2, The Janet Mandelbaum 2021 Irrevocable Gift Trust No 2, The Simcha Mandelbaum 2021 Irrevocable Gift Trust No. 2

  CMS ownership
• Garden Grove Convalescent Hospital Inc

  dba Garden Grove Convalescent Hospital & Guest Home

  • Skilled Nursing Facility
  • Garden Grove, CA
  • NPI 1295722809

  The Bentzion Mandelbaum 2021 Irrevocable Gift Trust No. 2, The Janet Mandelbaum 2021 Irrevocable Gift Trust No 2, The Simcha Mandelbaum 2021 Irrevocable Gift Trust No. 2

  CMS ownership
• Grand Valley Health Care Center LLC

  dba Grand Valley Health Care Center

  • Skilled Nursing Facility
  • Van Nuys, CA
  • NPI 1073950614

  The Bentzion Mandelbaum 2021 Irrevocable Gift Trust No. 2, The Janet Mandelbaum 2021 Irrevocable Gift Trust No 2, The Simcha Mandelbaum 2021 Irrevocable Gift Trust No. 2

  CMS ownership
• Long Beach Post Acute LLC

  dba Long Beach Post Acute

  • Skilled Nursing Facility
  • Long Beach, CA
  • NPI 1811390693

  The Bentzion Mandelbaum 2021 Irrevocable Gift Trust No. 2, The Janet Mandelbaum 2021 Irrevocable Gift Trust No 2, The Simcha Mandelbaum 2021 Irrevocable Gift Trust No. 2

  CMS ownership
• New Vista Nursing Operator, LLC

  dba New Vista Nursing & Rehabilitation Center

  • Skilled Nursing Facility
  • Sunland, CA
  • NPI 1154669794

  The Bentzion Mandelbaum 2021 Irrevocable Gift Trust No. 2, The Janet Mandelbaum 2021 Irrevocable Gift Trust No 2

  CMS ownership
• New Vista Pac Operator, LLC

  dba New Vista Post Acute Care Center

  • Skilled Nursing Facility
  • Los Angeles, CA
  • NPI 1881932424

  The Bentzion Mandelbaum 2021 Irrevocable Gift Trust No. 2, The Janet Mandelbaum 2021 Irrevocable Gift Trust No 2, The Simcha Mandelbaum 2021 Irrevocable Gift Trust No. 2

  CMS ownership

Affiliated clinicians 7

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

• Anooshiravan Hami, M.D.

  • Pulmonary Disease Physician
  • Anaheim, CA
  • NPI 1760580716

  Nursing home

  Care Compare affiliation
• Chin SE Kim, M.D.

  • Sports Medicine (Neuromusculoskeletal Medicine) Physician
  • Anaheim, CA
  • NPI 1477564607

  Nursing home

  Care Compare affiliation
• John Shin Kim, M.D.

  • Family Medicine Physician
  • Cerritos, CA
  • NPI 1003991159

  Nursing home

  Care Compare affiliation
• Daniel Kwon, DO

  • Geriatric Medicine (Family Medicine) Physician
  • Paramount, CA
  • NPI 1639736846

  Nursing home

  Care Compare affiliation
• Fariborz Shams, D.O.

  • Internal Medicine Physician
  • Anaheim, CA
  • NPI 1063421865

  Nursing home

  Care Compare affiliation
• Joseph Hyogoo Yi, MD

  • Family Medicine Physician
  • Buena Park, CA
  • NPI 1861565285

  Nursing home

  Care Compare affiliation
• Su Yong Pak, M.D.

  • Internal Medicine Physician
  • Lynnwood, WA
  • NPI 1437169372

  Nursing home

  Care Compare affiliation

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

{
    "created_epoch": "1127865600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1779926400000",
    "number": "1497742167",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4115 E BROADWAY",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908031532",
            "telephone_number": "562-930-0777",
            "fax_number": "562-930-0728"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8520 WESTERN AVE",
            "city": "BUENA PARK",
            "state": "CA",
            "postal_code": "906203927",
            "telephone_number": "714-828-8222",
            "fax_number": "714-828-1467"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "8520 WESTERN AVENUE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-28",
        "last_updated": "2026-05-28",
        "certification_date": "2026-05-28",
        "status": "A",
        "authorized_official_last_name": "SY",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "HENRY",
        "authorized_official_title_or_position": "VP OF REVENUE MANAGEMENT",
        "authorized_official_telephone_number": "562-930-0777",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "CA",
            "license": "060000106",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ZZT05571K",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "LTC70148F",
            "state": "CA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://199.119.81.30:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRResponse_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.1066.1",
            "affiliationName": "eSolutions Inc",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CSV",
            "address_1": "8215 W 108th Ter",
            "city": "Overland Park",
            "state": "KS",
            "country_code": "US",
            "postal_code": "662101661",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "BUENA PARK NURSING CENTER",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Skilled Nursing Facility in Buena Park, CA
• Providers in Buena Park, CA by specialty
• Skilled Nursing Facility in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2026; 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.

Verify at the official NPI Registry.