Active NPI
PC Care, LLC
Doing business as Pacific Post-Acute
- Skilled Nursing Facility
- Santa Monica, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Skilled Nursing Facility
- License
- 910000082
- Legal business name
- PC CARE, LLC
- Doing business as
- Pacific Post-Acute
- Practice address
- 1323 17TH Street
Santa Monica, CA 90404 - Phone
- (310) 453-5456
- Fax
- (310) 453-4247
- NPI assigned
- Sep 16, 2006
- Last updated
- Jul 13, 2016
- 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
- Mr. William C Presnell
- Title
- Cfo
- Phone
- (714) 577-3880
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | 910000082 | CA | Primary |
Addresses
Primary practice location
1323 17TH Street
Santa Monica, CA 90404
Mailing address
3050 Saturn Street
Suite #201
Brea, CA 92821-6278
Phone (714) 577-3880
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| LTC55054F | Medicaid | CA |
Other names 1
- Pacific Post-Acute
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20110225000718 | CA | Part A Provider - Skilled Nursing Facility | 3678754405 | Practice locations: Santa Monica, CA |
NPI to CCN mapping 1
The Medicare certification numbers (CCNs) connected to NPI 1609972520. Details of each certification follow.
Skilled nursing facility certification: CCN 555054
- Legal name
- PC CARE LLC
- Doing business as
- PACIFIC POST-ACUTE
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF/NF dual certification
- Participating since
- Mar 10, 1977
- Last certification
- Jan 23, 2025
- Beds
- 49
- Ownership / control type
- Limited Liability Corporation
- Organization structure
- LLC
- Enrollment address
- 1323 17TH St
Santa Monica, CA 90404-1901 - Nursing home name
- PACIFIC POST ACUTE
- Affiliated entity
- DAVID JOHNSON
Care Compare: Nursing home
Medicare Care Compare- Listed as
- Pacific Post Acute
- Overall star rating
- Health inspections
- Staffing
- Quality measures
- Type
- Medicare and Medicaid
- Ownership
- For profit - Limited Liability company
- Certified
- Mar 10, 1977
- Medicare certification status
- Active
- Certified beds
- 49
- Chain
- David Johnson
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 |
|---|---|---|---|
| 05D0550263 | Pacific Post-Acute | Certificate of waiver | Aug 31, 2026 |
National Provider Directory
National Provider DirectoryOwnership & related parties
All disclosed owners & managing parties 14
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 |
|---|---|---|---|
| Sun Mar Management Services | Adp of the SNF | Oct 12, 1989 | |
| Niceto Lopez | Adp of the SNF | Jan 1, 2017 | |
| David a Johnson | 5% Or Greater Indirect Ownership Interest | Jul 25, 2001 | 16.67% |
| PC Care LLC | 5% Or Greater Direct Ownership Interest | May 1, 2001 | 100% |
| Operational/Managerial Control | May 1, 2001 | ||
| Adp of the SNF | May 1, 2001 | ||
| Micheal D Oxford | Operational/Managerial Control | Jan 3, 2022 | |
| Adp of the SNF | Jan 3, 2022 | ||
| Frank a Johnson | 5% Or Greater Indirect Ownership Interest | Mar 1, 2022 | 50% |
| Operational/Managerial Control | Jul 25, 2001 | ||
| Managing Control - Governing Body | Jul 25, 2001 | ||
| Samuel Zack | Operational/Managerial Control | May 6, 2024 | |
| Adp of the SNF | May 6, 2024 | ||
| Joshua Kochek | Operational/Managerial Control | Apr 1, 2022 | |
| Adp of the SNF | Apr 1, 2022 | ||
| Virginia Ypil | Operational/Managerial Control | Aug 3, 2021 | |
| Eli Marmur | 5% Or Greater Indirect Ownership Interest | May 1, 2001 | 33.33% |
| Adp of the SNF | Jan 5, 1966 | ||
| Adrian Dehghanmanesh | Operational/Managerial Control | Jun 1, 2021 | |
| Adp of the SNF | Jun 1, 2021 | ||
| Mary Farrales | Adp of the SNF | Jan 1, 2023 | |
| Adp of the SNF | May 25, 2026 |
Owners & managing parties with NPI records 2
Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.
-
- Physical Therapist
- Los Angeles, CA
- NPI 1720199664
5% Or Greater Indirect Ownership Interest
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
-
- Physical Therapist
- Los Angeles, CA
- NPI 1720199664
Affiliated clinicians 8
Clinicians who list this facility as an affiliation in Medicare Care Compare.
-
- Hospice and Palliative Medicine (Internal Medicine) Physician
- Santa Monica, CA
- NPI 1255726485
Nursing home
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158364800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1468368000000",
"number": "1609972520",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3050 SATURN STREET",
"address_2": "SUITE #201",
"city": "BREA",
"state": "CA",
"postal_code": "928216278",
"telephone_number": "714-577-3880",
"fax_number": "714-577-3895"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1323 17TH STREET",
"city": "SANTA MONICA",
"state": "CA",
"postal_code": "90404",
"telephone_number": "310-453-5456",
"fax_number": "310-453-4247"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "PC CARE, LLC",
"organizational_subpart": "NO",
"enumeration_date": "2006-09-16",
"last_updated": "2016-07-13",
"status": "A",
"authorized_official_last_name": "PRESNELL",
"authorized_official_first_name": "WILLIAM",
"authorized_official_middle_name": "C",
"authorized_official_title_or_position": "CFO",
"authorized_official_telephone_number": "714-577-3880",
"authorized_official_name_prefix": "Mr."
},
"taxonomies": [
{
"code": "314000000X",
"taxonomy_group": "",
"desc": "Skilled Nursing Facility",
"state": "CA",
"license": "910000082",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "LTC55054F",
"state": "CA"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Pacific Post-Acute",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Santa Monica, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2016; 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.