Organization Active NPI

PC Care, LLC

Doing business as Pacific Post-Acute

  • Skilled Nursing Facility
  • Santa Monica, CA
National Provider Identifier
1609972520
Registry record updated Jul 13, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
910000082 Issued in CA
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, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2016

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)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
LTC55054FMedicaidCA

Other names 1

  • Pacific 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
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
LLCProprietary
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 AcuteCCN 555054 · All quality measures
Overall star rating
5 of 5
Health inspections
4 of 5
Staffing
3 of 5
Quality measures
5 of 5
Type
Medicare and Medicaid
Ownership
For profit - Limited Liability company
Certified
Mar 10, 1977
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
4940.3 residents per day on average
Chain
David Johnson48 facilities in the chain

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
05D0550263Pacific Post-Acute1323 17TH Street, Santa Monica, CA 90404Certificate of waiverAug 31, 2026

National Provider Directory

National Provider Directory

Ownership & 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.

NameRoleSinceShare
Sun Mar Management Services Organization, Brea, CA Corporation, For-profit Adp of the SNF Oct 12, 1989
Niceto Lopez Individual Adp of the SNF Jan 1, 2017
David a Johnson Individual 5% Or Greater Indirect Ownership Interest Jul 25, 2001 16.67%
PC Care LLC Organization, Brea, CA Created for acquisition, LLC, For-profit, Owned by another organization or individual 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 Individual Operational/Managerial Control Jan 3, 2022
Adp of the SNF Jan 3, 2022
Frank a Johnson Individual 5% Or Greater Indirect Ownership Interest Mar 1, 2022 50%
Operational/Managerial Control Jul 25, 2001
Managing Control - Governing BodyManager Jul 25, 2001
Samuel Zack Individual Operational/Managerial Control May 6, 2024
Adp of the SNF May 6, 2024
Joshua Kochek Individual Operational/Managerial Control Apr 1, 2022
Adp of the SNF Apr 1, 2022
Virginia Ypil Individual Operational/Managerial Control Aug 3, 2021
Eli Marmur Individual 5% Or Greater Indirect Ownership Interest May 1, 2001 33.33%
Organization, Oak Park, CA Adp of the SNF Jan 5, 1966
Adrian Dehghanmanesh Individual Operational/Managerial Control Jun 1, 2021
Adp of the SNF Jun 1, 2021
Mary Farrales Individual Adp of the SNF Jan 1, 2023
Organization, Chicago, IL Financial institution, For-profit 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.

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.

Affiliated clinicians 8

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": "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

Verify at the official NPI Registry.