NPIMap

Organization Active NPI

1030 Warner Avenue I Opco, LLC

Doing business as Santa Ana TRC

  • Skilled Nursing Facility
  • Santa Ana, CA
National Provider Identifier
1508565987
Registry record updated Jul 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
1030 WARNER AVENUE I OPCO, LLC
Doing business as
Santa Ana TRC
South Coast Post Acute
Practice address
1030 W Warner Ave
Santa Ana, CA 92707-3147
Phone
(714) 547-6450
NPI assigned
Feb 24, 2023
Last updated
Jul 29, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2024

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

Authorized official

Name
Pamela D Shaw
Title
SVP RCM
Phone
(760) 445-0699

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X Primary

Addresses

Primary practice location

1030 W Warner Ave
Santa Ana, CA 92707-3147

Mailing address

1030 W Warner Ave
Santa Ana, CA 92707-3147
Phone (714) 546-6450

Other names 2

  • SANTA ANA TRC Doing business as
  • South Coast Post Acute Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230907002357 CA Part A Provider - Skilled Nursing Facility 2062876154 Practice locations: Santa Ana, CA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1508565987. Details of each certification follow.

Skilled nursing facility certification: CCN 055653

Legal name
1030 WARNER AVENUE I OPCO LLC
Doing business as
SOUTH COAST POST ACUTE
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Jun 1, 1974
Last certification
Feb 28, 2025
Beds
255
Ownership / control type
Limited Liability Corporation
Organization structure
LLCProprietary
Enrollment address
1030 W Warner Ave
Santa Ana, CA 92707-3147
Nursing home name
SOUTH COAST POST ACUTE
Affiliated entity
WINDSOR

Care Compare: Nursing home

Medicare Care Compare
Listed as
South Coast Post AcuteCCN 055653 · All quality measures
Overall star rating
2 of 5
Health inspections
2 of 5
Staffing
4 of 5
Quality measures
4 of 5
Type
Medicare and Medicaid
Ownership
For profit - Limited Liability company
Certified
Jun 1, 1974
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
255240.8 residents per day on average
Chain
Windsor22 facilities in the chain
Abuse citation
Cited for abuse (Care Compare abuse icon)

Processed by Care Compare on Aug 1, 2026.

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
05D0581441South Coast Post Acute1030 West Warner Ave, Santa Ana, CA 92707Certificate of waiverAug 31, 2026

National Provider Directory

National Provider Directory

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
9560 Pico LLC Organization, Los Angeles, CA LLC, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Nov 14, 2022 50%
Meshuga 2 Realty Holdings LLC Organization, Los Angeles, CA LLC, Holding company Adp of the SNF Jul 14, 2025
Pico Ar LLC Organization, Los Angeles, CA LLC, Holding company, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Nov 14, 2022 50%
Newgen Administrative Services, LLC Organization, Los Angeles, CA LLC, For-profit Adp of the SNF Feb 28, 2025
Christopher E Salem Individual Operational/Managerial Control Jun 1, 2019
Adp of the SNF Jun 1, 2019
Avrohom L Tress Individual 5% Or Greater Indirect Ownership Interest Mar 24, 2023 50%
Corporate OfficerVice President Mar 24, 2023
Pamela Shaw Individual Operational/Managerial Control Mar 24, 2023
Miguel Hurtado Individual Operational/Managerial Control Mar 7, 2023
Adp of the SNF Mar 7, 2023
Aaron H Robin Individual 5% Or Greater Indirect Ownership Interest Mar 24, 2023 50%
Corporate OfficerPresident Mar 24, 2023

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 43

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

View all 43

Practitioners & affiliated clinicians

Affiliated clinicians 4

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

NPI Registry JSON

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

{
    "created_epoch": "1677196800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1722211200000",
    "number": "1508565987",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1030 W WARNER AVE",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927073147",
            "telephone_number": "714-546-6450",
            "fax_number": "714-546-8411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1030 W WARNER AVE",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927073147",
            "telephone_number": "714-547-6450"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "1030 WARNER AVENUE I OPCO, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-02-24",
        "last_updated": "2024-07-29",
        "certification_date": "2024-07-29",
        "status": "A",
        "authorized_official_last_name": "SHAW",
        "authorized_official_first_name": "PAMELA",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "SVP RCM",
        "authorized_official_telephone_number": "760-445-0699"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SANTA ANA TRC",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "South Coast Post Acute",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Santa Ana, CA

Sources for this page

Verify at the official NPI Registry.