NPIMap

Organization Active NPI

Rose Park Healthcare Associates,Inc.

Doing business as Shoreline Healthcare Center

  • Skilled Nursing Facility
  • Long Beach, CA
National Provider Identifier
1811996507
Registry record updated Feb 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
940000057 Issued in CA
Legal business name
ROSE PARK HEALTHCARE ASSOCIATES,INC.
Doing business as
Shoreline Healthcare Center
Practice address
4029 E Anaheim St
Long Beach, CA 90804-4110
Phone
(562) 494-4421
Fax
(562) 494-2731
NPI assigned
Jul 15, 2005
Last updated
Feb 17, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 17, 2021

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

Authorized official

Name
Soon Burnam
Title
Treasurer
Phone
(949) 540-1249

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 940000057 CA Primary

Addresses

Primary practice location

4029 E Anaheim St
Long Beach, CA 90804-4110

Mailing address

4029 E Anaheim St
Long Beach, CA 90804-4110
Phone (562) 494-4421

Other identifiers 1

IdentifierTypeStateIssuer
ZZT05353GMedicaidCA

Other names 1

  • Shoreline Healthcare Center Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://199.119.81.30:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRResponse_Service Other eSolutions Inc.

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20030120000021 CA Part A Provider - Skilled Nursing Facility 8921916784 Practice locations: Long Beach, CA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1811996507. Details of each certification follow.

Skilled nursing facility certification: CCN 055353

Legal name
ROSE PARK HEALTHCARE ASSOCIATES,INC.
Doing business as
SHORELINE HEALTHCARE CENTER
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Jan 1, 1967
Last certification
Apr 18, 2025
Beds
75
Ownership / control type
Corporation
Multi-facility organization
Flagstone
Organization structure
CorporationProprietary
Incorporated
Jun 20, 2002 in NV
Enrollment address
4029 E Anaheim St
Long Beach, CA 90804-4110
Nursing home name
SHORELINE HEALTHCARE CENTER
Affiliated entity
THE ENSIGN GROUP

Care Compare: Nursing home

Medicare Care Compare
Listed as
Shoreline Healthcare CenterCCN 055353 · All quality measures
Overall star rating
3 of 5
Health inspections
2 of 5
Staffing
3 of 5
Quality measures
5 of 5
Type
Medicare and Medicaid
Ownership
For profit - Corporation
Certified
Jan 1, 1967
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
7563.8 residents per day on average
Chain
The Ensign Group342 facilities in the chain
Penalties (3 years)
1Fines totaling $41,629

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
05D0694483Shoreline Healthcare Center4029 East Anaheim Street, Long Beach, CA 90804Certificate of waiverAug 31, 2026

National Provider Directory

National Provider Directory

Locations

4029 E Anaheim St
Long Beach, CA 90804
Phone (562) 494-4421

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
Jesse Kim Individual Corporate OfficerPresident Rose Park Healthcare Asso Jan 1, 2023
Sheilla Ortiz-Luis Individual Operational/Managerial ControlAdministrator Jan 1, 2017
Managing Control - Governing BodyAdministrator Jan 1, 2017
Adp of the SNF Jul 8, 2025
The Ensign Group Inc Organization, San Juan Capistrano, CA Corporation 5% Or Greater Indirect Ownership Interest Jan 30, 2006 100%
Ensign Services Inc Organization, San Juan Capistrano, CA Corporation Operational/Managerial Control Aug 1, 2002
Adp of the SNF Jul 18, 2025
Adam Willits Individual Corporate DirectorDirector Rose Park Healthcare Assoc Jan 1, 2023
Ami Sato Individual Corporate OfficerTreasurer Rose Park Healthcare Asso Sep 9, 2024
Flagstone Healthcare South LLC Organization, San Juan Capistrano, CA LLC 5% Or Greater Direct Ownership Interest Jul 1, 2002 100%
Ctr Partnership LP Organization, San Clemente, CA Adp of the SNF Jul 1, 2002
Caretrust GP LLC Organization, San Clemente, CA LLC Adp of the SNF Jul 1, 2002
Caretrust Reit Inc Organization, San Clemente, CA Corporation Adp of the SNF Jul 1, 2002
Ben Zandpour Individual Operational/Managerial Control Sep 1, 2015
Managing Control - Governing BodyMedical Director Sep 1, 2015
Adp of the SNF Jul 8, 2025
Long Beach Health Associates LLC Organization, San Clemente, CA LLC Adp of the SNF Jul 1, 2002
Chad Keetch Individual Corporate OfficerSecretary Ensign Services, Inc. Mar 1, 2011
Soon Burnam Individual Corporate OfficerSecretary Rose Park Healthcare Asso Jan 30, 2006
Managing Control - Governing BodySecretary Rose Park Healthcare Asso Jan 30, 2006

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

  • Ben Zandpour, MD
    • Internal Medicine Physician
    • Rancho Palos Verdes, CA
    • NPI 1386655843

    Adp of the SNF, Managing Control - Governing Body, Operational/Managerial Control

    CMS ownership

Facilities with the same owner 39

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

View all 39

Practitioners & affiliated clinicians

Affiliated clinicians 5

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": "1121385600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1613520000000",
    "number": "1811996507",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4029 E ANAHEIM ST",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908044110",
            "telephone_number": "562-494-4421",
            "fax_number": "562-494-2731"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4029 E ANAHEIM ST",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908044110",
            "telephone_number": "562-494-4421",
            "fax_number": "562-494-2731"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROSE PARK HEALTHCARE ASSOCIATES,INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-07-15",
        "last_updated": "2021-02-17",
        "certification_date": "2021-02-17",
        "status": "A",
        "authorized_official_last_name": "BURNAM",
        "authorized_official_first_name": "SOON",
        "authorized_official_title_or_position": "TREASURER",
        "authorized_official_telephone_number": "949-540-1249"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "CA",
            "license": "940000057",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ZZT05353G",
            "state": "CA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://199.119.81.30:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRResponse_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113833.3.1066.1",
            "affiliationName": "eSolutions Inc.",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "8215 W 108th Ter",
            "city": "Overland Park",
            "state": "KS",
            "country_code": "US",
            "postal_code": "662101661",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Shoreline Healthcare Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Shoreline Healthcare Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Long Beach, CA

Sources for this page

Verify at the official NPI Registry.