NPIMap

Organization Active NPI

Department of Veterans Affairs of the State of California

Doing business as Veterans Home of California - West Los Angeles

  • Skilled Nursing Facility
  • Los Angeles, CA
National Provider Identifier
1821316076
Registry record updated May 15, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
550002051 Issued in CA
Legal business name
DEPARTMENT OF VETERANS AFFAIRS OF THE STATE OF CALIFORNIA
Doing business as
Veterans Home of California - West Los Angeles
Practice address
11500 Nimitz Ave
Los Angeles, CA 90049-3566
Phone
(818) 742-1752
Fax
(818) 742-1758
NPI assigned
May 12, 2010
Last updated
May 15, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 15, 2020

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

Authorized official

Name
Ani Khachatoorian
Title
Finance Manager
Phone
(424) 832-8551

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X 197607966 CA
Skilled Nursing Facility 314000000X 550002051 CA Primary

Addresses

Primary practice location

11500 Nimitz Ave
Los Angeles, CA 90049-3566

Mailing address

PO Box 942895
Sacramento, CA 94295-0001
Phone (916) 657-9349

Other names 1

  • Veterans Home of California - West Los Angeles Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20150818004043 CA Part B Supplier - Clinic/Group Practice 6507099520 Receives reassigned benefits from 21 practitioners
2 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Fresno, CA; Los Angeles, CA; Redding, CA
O20180911001856 CA Part A Provider - Skilled Nursing Facility 6507099520 Practice locations: Los Angeles, CA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1821316076. Details of each certification follow.

Skilled nursing facility certification: CCN 555917

Legal name
DEPARTMENT OF VETERANS AFFAIRS OF THE STATE OF CALIFORNIA
Doing business as
VETERANS HOME OF CALIFORNIA - WEST LA
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Nov 21, 2019
Last certification
Dec 6, 2024
Beds
312
Ownership / control type
State
Organization structure
GovernmentNon-profit
Enrollment address
11500 Nimitz Ave
Los Angeles, CA 90049-3566
Nursing home name
VETERANS HOME OF CALIFORNIA - WEST LOS ANGELES

Other NPIs with the same Medicare PAC ID 2

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Care Compare: Nursing home

Medicare Care Compare
Listed as
Veterans Home of California - West Los AngelesCCN 555917 · All quality measures
Overall star rating
3 of 5
Health inspections
2 of 5
Staffing
5 of 5
Quality measures
4 of 5
Type
Medicare and Medicaid
Ownership
Government - State
Certified
Nov 21, 2019
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
312143.1 residents per day on average

Processed by Care Compare on Aug 1, 2026.

National Provider Directory

National Provider Directory
Tax ID family
Department of Veterans Affairs of the State of California7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

Organizations that report the same tax identification number in the National Provider Directory.

Locations

11500 Nimitz Ave
Los Angeles, CA 90049
Phone (424) 832-8200

1227 O St
Rm 403
Sacramento, CA 95814

Ownership & related parties

All disclosed owners & managing parties 4

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Kevin M McGuire Individual W-2 Managing EmployeeSkilled Nursing Administrator Oct 15, 2017
Department of Veterans Affairs of the State of California Organization, Los Angeles, CA 5% Or Greater Direct Ownership Interest Oct 3, 2010 100%
Operational/Managerial Control Jun 1, 2018
Brian D Nanoo Individual Operational/Managerial ControlMedical Cost Recovery Manager Jun 1, 2018
Cindy L Lindsey Individual Operational/Managerial ControlCal Vet Accounting Chief Jun 1, 2018

Owners & managing parties with NPI records 2

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

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Veterans Home of California ReddingRedding, CA, CCN 555891 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control
Adp of the SNF		 Oct 22, 2013
Oct 22, 2013
Oct 22, 2013
Veterans Home of California - FresnoFresno, CA, CCN 555900 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control
Adp of the SNF		 Oct 13, 2013
Oct 13, 2013
Oct 13, 2013

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Facilities with the same owner 2

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

Practitioners & affiliated clinicians

Practitioners 22

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.

View all 22

Affiliated clinicians 3

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": "1273622400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1589500800000",
    "number": "1821316076",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 942895",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "942950001",
            "telephone_number": "916-657-9349",
            "fax_number": "916-653-1795"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11500 NIMITZ AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900493566",
            "telephone_number": "818-742-1752",
            "fax_number": "818-742-1758"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEPARTMENT OF VETERANS AFFAIRS OF THE STATE OF CALIFORNIA",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-05-12",
        "last_updated": "2020-05-15",
        "certification_date": "2020-05-15",
        "status": "A",
        "authorized_official_last_name": "KHACHATOORIAN",
        "authorized_official_first_name": "ANI",
        "authorized_official_title_or_position": "FINANCE MANAGER",
        "authorized_official_telephone_number": "424-832-8551"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "CA",
            "license": "197607966",
            "primary": false
        },
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "CA",
            "license": "550002051",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Veterans Home of California - West Los Angeles",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Veterans Home of California - West Los Angeles",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.