Active NPI
Culver West Health Center, LLC
Doing business as Culver West Health Center
- Skilled Nursing Facility
- Los Angeles, CA
National Provider Identifier
1710379946
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Skilled Nursing Facility
- License
- 910000038
- Legal business name
- CULVER WEST HEALTH CENTER, LLC
- Doing business as
- Culver West Health Center
- Practice address
- 4035 Grand View Blvd
Los Angeles, CA 90066-5211 - Phone
- (714) 310-3909
- Fax
- (310) 398-7470
- NPI assigned
- Feb 25, 2015
- Last updated
- Oct 21, 2015
- 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
- Harry Jacobs
- Title
- Manager
- Phone
- (310) 390-9506
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | 910000038 | CA | Primary |
Addresses
Primary practice location
4035 Grand View Blvd
Los Angeles, CA 90066-5211
Mailing address
4035 Grand View Blvd
Los Angeles, CA 90066-5211
Phone (714) 310-3909
Other names 1
- Culver West Health Center
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20140808001387 | CA | Part A Provider - Skilled Nursing Facility | 4082831425 | Practice locations: Los Angeles, CA |
NPI to CCN mapping 1
The Medicare certification numbers (CCNs) connected to NPI 1710379946. Details of each certification follow.
Skilled nursing facility certification: CCN 055350
- Legal name
- CULVER WEST HEALTH CENTER LLC
- Doing business as
- CULVER WEST HEALTH CENTER
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF/NF dual certification
- Participating since
- Jan 1, 1967
- Last certification
- May 2, 2025
- Beds
- 91
- Ownership / control type
- Limited Liability Corporation
- Most recent change of ownership
- Jul 1, 2014
- Organization structure
- LLC
- Incorporated
- Apr 29, 2014 in CA
- Enrollment address
- 4035 Grand View Blvd
Los Angeles, CA 90066-5211 - Nursing home name
- CULVER WEST HEALTH CENTER
Care Compare: Nursing home
Medicare Care Compare- Listed as
- Culver West Health Center
- Overall star rating
- Health inspections
- Staffing
- Quality measures
- Type
- Medicare and Medicaid
- Ownership
- For profit - Limited Liability company
- Certified
- Jan 1, 1967
- Medicare certification status
- Active
- Certified beds
- 91
- Penalties (3 years)
- 1
National Provider Directory
National Provider DirectoryOwnership & related parties
All disclosed owners & managing parties 3
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 |
|---|---|---|---|
| Harry Jacobs | Corporate Officer | Jul 1, 2014 | |
| Culver West Health Center LLC | 5% Or Greater Direct Ownership Interest | Jul 1, 2014 | 100% |
| Ross Maultasch | W-2 Managing Employee | Jul 1, 2014 |
Practitioners & affiliated clinicians
Affiliated clinicians 7
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": "1424822400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1445385600000",
"number": "1710379946",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4035 GRAND VIEW BLVD",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900665211",
"telephone_number": "714-310-3909",
"fax_number": "310-398-7470"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4035 GRAND VIEW BLVD",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900665211",
"telephone_number": "714-310-3909",
"fax_number": "310-398-7470"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "CULVER WEST HEALTH CENTER, LLC",
"organizational_subpart": "NO",
"enumeration_date": "2015-02-25",
"last_updated": "2015-10-21",
"status": "A",
"authorized_official_last_name": "JACOBS",
"authorized_official_first_name": "HARRY",
"authorized_official_title_or_position": "MANAGER",
"authorized_official_telephone_number": "310-390-9506"
},
"taxonomies": [
{
"code": "314000000X",
"taxonomy_group": "",
"desc": "Skilled Nursing Facility",
"state": "CA",
"license": "910000038",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Culver West Health Center",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Los Angeles, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2015; 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.