Active NPI
Puente Partners,LLC
- Skilled Nursing Facility
- Baldwin Park, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Skilled Nursing Facility
- License
- 950000077
- Legal business name
- PUENTE PARTNERS,LLC
- Practice address
- 3541 Puente Ave
Baldwin Park, CA 91706-5534 - Phone
- (626) 962-1043
- Fax
- (626) 337-2142
- NPI assigned
- Jul 24, 2008
- 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
- Jeanne Nelson
- Title
- Ar Manager
- Phone
- (714) 577-3880
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | 950000077 | CA | Primary |
Addresses
Primary practice location
3541 Puente Ave
Baldwin Park, CA 91706-5534
Mailing address
3050 Saturn St
Ste201
Brea, CA 92821-6221
Phone (714) 577-3880
Other names 1
- Victoria Care 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 |
|---|---|---|---|---|
| O20090410000050 | CA | Part A Provider - Skilled Nursing Facility | 9335201763 | Practice locations: Baldwin Park, CA |
Skilled nursing facility certification: CCN 555107
- Legal name
- PUENTE PARTNERS LLC
- Doing business as
- VICTORIA CARE CENTER
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF/NF dual certification
- Participating since
- Feb 5, 1979
- Last certification
- Feb 16, 2025
- Beds
- 49
- Ownership / control type
- Limited Liability Corporation
- Multi-facility organization
- Sunmar Healthcare
- Organization structure
- LLC
- Enrollment address
- 3541 Puente Ave
Baldwin Park, CA 91706-5534 - Nursing home name
- VICTORIA CARE CENTER
- Affiliated entity
- DAVID JOHNSON
Care Compare: Nursing home
Medicare Care Compare- Listed as
- Victoria Care Center
- Overall star rating
- Health inspections
- Staffing
- Quality measures
- Type
- Medicare and Medicaid
- Ownership
- For profit - Limited Liability company
- Certified
- Feb 5, 1979
- 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 |
|---|---|---|---|
| 05D0881826 | Victoria Care Center | Certificate of waiver | Jan 23, 2028 |
National Provider Directory
National Provider DirectoryOwnership & related parties
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.
| Name | Role | Since | Share |
|---|---|---|---|
| Sun Mar Management Services | Adp of the SNF | Oct 12, 1989 | |
| Rose Baldwin Park Property LP | 5% Or Greater Security Interest | Feb 11, 2025 | |
| Adp of the SNF | Feb 11, 2025 | ||
| Naveen Kumar Dhiman | Operational/Managerial Control | Aug 10, 2024 | |
| Adp of the SNF | Jan 1, 2023 | ||
| Adp of the SNF | Apr 8, 2025 | ||
| David a Johnson | 5% Or Greater Indirect Ownership Interest | Jun 10, 2008 | 30% |
| 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 | Jun 10, 2008 | 30% |
| Operational/Managerial Control | Jun 10, 2008 | ||
| Managing Control - Governing Body | Jun 10, 2008 | ||
| Joshua Kochek | Operational/Managerial Control | Apr 1, 2022 | |
| Adp of the SNF | Apr 1, 2022 | ||
| Eli Marmur | 5% Or Greater Indirect Ownership Interest | Jun 10, 2008 | 20% |
| Thomas M Chambers | 5% Or Greater Indirect Ownership Interest | Jun 10, 2008 | 20% |
| Adrian Dehghanmanesh | Operational/Managerial Control | Jun 1, 2021 | |
| Adp of the SNF | Jun 1, 2021 | ||
| Joshua Brice | Operational/Managerial Control | Oct 24, 2024 | |
| Adp of the SNF | Oct 24, 2024 | ||
| Mary Farrales | Adp of the SNF | Jan 1, 2023 | |
| Puente Partners LLC | 5% Or Greater Direct Ownership Interest | Oct 30, 2008 | 100% |
| Operational/Managerial Control | Oct 30, 2008 | ||
| Adp of the SNF | Oct 30, 2008 | ||
| Pearson Chimwaza | Operational/Managerial Control | Sep 16, 2024 | |
| Adp of the SNF | Sep 16, 2024 |
Owners & managing parties with NPI records 2
Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.
-
- Family Medicine Physician
- Pacoima, CA
- NPI 1366696395
Adp of the SNF, Operational/Managerial Control
-
- Physical Therapist
- Los Angeles, CA
- NPI 1720199664
5% Or Greater Indirect Ownership Interest
Practitioners & affiliated clinicians
Affiliated clinicians 2
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": "1216857600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1241654400000",
"number": "1720243199",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3050 SATURN ST",
"address_2": "STE201",
"city": "BREA",
"state": "CA",
"postal_code": "928216221",
"telephone_number": "714-577-3880",
"fax_number": "714-577-3892"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3541 PUENTE AVE",
"city": "BALDWIN PARK",
"state": "CA",
"postal_code": "917065534",
"telephone_number": "626-962-1043",
"fax_number": "626-337-2142"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "PUENTE PARTNERS,LLC",
"organizational_subpart": "NO",
"enumeration_date": "2008-07-24",
"last_updated": "2009-05-07",
"status": "A",
"authorized_official_last_name": "NELSON",
"authorized_official_first_name": "JEANNE",
"authorized_official_title_or_position": "AR MANAGER",
"authorized_official_telephone_number": "714-577-3880"
},
"taxonomies": [
{
"code": "314000000X",
"taxonomy_group": "",
"desc": "Skilled Nursing Facility",
"state": "CA",
"license": "950000077",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Victoria Care Center",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Baldwin Park, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2009; 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.