Active NPI
Park Anaheim Health Care, LLC
- Skilled Nursing Facility
- Anaheim, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Skilled Nursing Facility
- License
- 060000094
- Legal business name
- PARK ANAHEIM HEALTH CARE, LLC
- Doing business as
- PARK ANAHEIM HEALTHCARE CENTER
- Practice address
- 3435 W Ball Rd
Anaheim, CA 92804-3708 - Phone
- (714) 827-5880
- Fax
- (714) 827-8815
- NPI assigned
- Nov 7, 2006
- 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
- David Friedman
- Title
- Managing Member
- Phone
- (213) 389-6900
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | 060000094 | CA | Primary |
Addresses
Primary practice location
3435 W Ball Rd
Anaheim, CA 92804-3708
Mailing address
4032 Wilshire Blvd FL 6
Los Angeles, CA 90010-3425
Phone (213) 389-6900
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| LTC55035G | Medicaid | CA | |
| LTC70120F | Medicaid | CA |
Other names 1
- PARK ANAHEIM HEALTHCARE CENTER
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
Enrollment records 2
Skilled nursing facility certification: CCN 555035
- Legal name
- PARK ANAHEIM HEALTH CARE, LLC
- Doing business as
- PARK ANAHEIM HEALTHCARE CENTER
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF/NF dual certification
- Participating since
- Nov 23, 1976
- Last certification
- Mar 14, 2025
- Beds
- 115
- Ownership / control type
- Corporation
- Organization structure
- LLC
- Enrollment address
- 3435 W Ball Rd
Anaheim, CA 92804-3708 - Nursing home name
- PARK ANAHEIM HEALTHCARE CENTER
- Affiliated entity
- LONGWOOD MANAGEMENT CORPORATION
Other NPIs on the same Medicare enrollment 1
NPIs listed together on one Medicare enrollment, typically parts of the same organization.
-
- Internal Medicine Physician
- Anaheim, CA
- NPI 1245533926
O20110524000109
Care Compare: Nursing home
Medicare Care Compare- Listed as
- Park Anaheim Healthcare Center
- Overall star rating
- Health inspections
- Staffing
- Quality measures
- Type
- Medicare and Medicaid
- Ownership
- For profit - Corporation
- Certified
- Nov 23, 1976
- Medicare certification status
- Active
- Certified beds
- 115
- Chain
- Longwood Management Corporation
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 |
|---|---|---|---|
| 05D0885673 | Park Anaheim Healthcare Center | Certificate of waiver | Apr 27, 2028 |
National Provider Directory
National Provider DirectoryLocations
3455 W Ball Rd
Anaheim, CA 92804
Ownership & related parties
All disclosed owners & managing parties 25
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 |
|---|---|---|---|
| Aaron Friedman | 5% Or Greater Indirect Ownership Interest | Jun 30, 2023 | 20% |
| Trustee of the SNF | Jun 30, 2023 | ||
| Adp of the SNF | Jun 30, 2023 | ||
| Adp of the SNF | Jun 30, 2023 | ||
| Libby Lehmann | 5% Or Greater Indirect Ownership Interest | Jun 30, 2023 | 20% |
| Trustee of the SNF | Jun 30, 2023 | ||
| Rachel Klavan | 5% Or Greater Indirect Ownership Interest | Jun 30, 2023 | 20% |
| Trustee of the SNF | Jun 30, 2023 | ||
| Adp of the SNF | Jun 30, 2023 | ||
| Fariborz Shams | Operational/Managerial Control | Jun 9, 2024 | |
| Adp of the SNF | Jun 9, 2024 | ||
| Lehmann Family 1991 Trust | 5% Or Greater Direct Ownership Interest | Jun 30, 2023 | 20% |
| Marissa Bansal | Operational/Managerial Control | Apr 4, 2018 | |
| Adp of the SNF | Apr 4, 2018 | ||
| The Klavan Family Trust | 5% Or Greater Direct Ownership Interest | Jun 30, 2023 | 20% |
| Adp of the SNF | Jun 30, 2023 | ||
| Joshua Klavan | Operational/Managerial Control | Dec 1, 2022 | |
| Adp of the SNF | Nov 16, 1986 | ||
| Adp of the SNF | Jun 30, 2023 | ||
| Adp of the SNF | Jun 30, 2023 | ||
| Adp of the SNF | Jun 30, 2023 | ||
| Longwood Management LLC | Adp of the SNF | Jan 1, 2023 | |
| Adp of the SNF | Jun 30, 2023 | ||
| Adp of the SNF | Jun 30, 2023 | ||
| The Tzippy Friedman Notis 1990 Trust | 5% Or Greater Direct Ownership Interest | Jun 30, 2023 | 20% |
| Adp of the SNF | Jun 30, 2023 | ||
| Ira D Friedman 1991 Trust | 5% Or Greater Direct Ownership Interest | Jun 30, 2023 | 20% |
| Friedman Family Trust | 5% Or Greater Direct Ownership Interest | Jun 30, 2023 | 20% |
| Caroline Bruso | Operational/Managerial Control | Feb 16, 2022 | |
| Adp of the SNF | Feb 16, 2022 | ||
| Adp of the SNF | Jun 30, 2023 | ||
| Ira David Friedman | 5% Or Greater Indirect Ownership Interest | Jun 30, 2023 | 20% |
| Corporate Officer | Apr 1, 1995 | 20% | |
| Operational/Managerial Control | Jun 30, 2023 | ||
| Managing Control - Governing Body | Jun 30, 2023 | ||
| Trustee of the SNF | Jun 30, 2023 | ||
| Adp of the SNF | Jun 30, 2023 | ||
| Zaid Pervaiz | Adp of the SNF | Jan 1, 2013 |
Owners & managing parties with NPI records 1
Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.
-
- Internal Medicine Physician
- Anaheim, CA
- NPI 1063421865
Adp of the SNF, Operational/Managerial Control
Facilities with the same owner 24
Facilities that share an organizational owner with 5% or greater ownership or operational control.
-
- Skilled Nursing Facility
- Sherman Oaks, CA
- NPI 1316018310
Friedman Family Trust, Ira D Friedman 1991 Trust, Lehmann Family 1991 Trust, The Klavan Family Trust, The Tzippy Friedman Notis 1990 Trust
-
- Community Based Hospice Care Agency
- Upland, CA
- NPI 1700280328
Friedman Family Trust, Ira D Friedman 1991 Trust, Lehmann Family 1991 Trust, The Klavan Family Trust, The Tzippy Friedman Notis 1990 Trust
-
- Skilled Nursing Facility
- Los Angeles, CA
- NPI 1568544781
Friedman Family Trust, Ira D Friedman 1991 Trust, Lehmann Family 1991 Trust, The Klavan Family Trust, The Tzippy Friedman Notis 1990 Trust
-
- Skilled Nursing Facility
- Burbank, CA
- NPI 1316019482
Friedman Family Trust, Ira D Friedman 1991 Trust, Lehmann Family 1991 Trust, The Klavan Family Trust, The Tzippy Friedman Notis 1990 Trust
-
- Skilled Nursing Facility
- Beaumont, CA
- NPI 1376963785
Friedman Family Trust, Ira D Friedman 1991 Trust, Lehmann Family 1991 Trust, The Klavan Family Trust, The Tzippy Friedman Notis 1990 Trust
-
- Skilled Nursing Facility
- Burbank, CA
- NPI 1518036060
Friedman Family Trust, Ira D Friedman 1991 Trust, Lehmann Family 1991 Trust, The Klavan Family Trust, The Tzippy Friedman Notis 1990 Trust
-
- Skilled Nursing Facility
- Canoga Park, CA
- NPI 1487734935
Friedman Family Trust, Ira D Friedman 1991 Trust, Lehmann Family 1991 Trust, The Klavan Family Trust, The Tzippy Friedman Notis 1990 Trust
-
- Skilled Nursing Facility
- Bellflower, CA
- NPI 1407373350
Friedman Family Trust, Ira D Friedman 1991 Trust, Lehmann Family 1991 Trust, The Klavan Family Trust, The Tzippy Friedman Notis 1990 Trust
-
- Skilled Nursing Facility
- Pomona, CA
- NPI 1558441022
Friedman Family Trust, Ira D Friedman 1991 Trust, Lehmann Family 1991 Trust, The Klavan Family Trust, The Tzippy Friedman Notis 1990 Trust
-
- Skilled Nursing Facility
- N Hollywood, CA
- NPI 1790854180
Friedman Family Trust, Ira D Friedman 1991 Trust, Lehmann Family 1991 Trust, The Klavan Family Trust, The Tzippy Friedman Notis 1990 Trust
-
- Skilled Nursing Facility
- Long Beach, CA
- NPI 1639257165
Friedman Family Trust, Ira D Friedman 1991 Trust, Lehmann Family 1991 Trust, The Klavan Family Trust, The Tzippy Friedman Notis 1990 Trust
-
- Skilled Nursing Facility
- Covina, CA
- NPI 1992885958
Friedman Family Trust, Ira D Friedman 1991 Trust, Lehmann Family 1991 Trust, The Klavan Family Trust, The Tzippy Friedman Notis 1990 Trust
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Internal Medicine Physician
- Anaheim, CA
- NPI 1831227669
Affiliated clinicians 6
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": "1162857600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1525910400000",
"number": "1851460240",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4032 WILSHIRE BLVD FL 6",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900103425",
"telephone_number": "213-389-6900",
"fax_number": "213-368-8560"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3435 W BALL RD",
"city": "ANAHEIM",
"state": "CA",
"postal_code": "928043708",
"telephone_number": "714-827-5880",
"fax_number": "714-827-8815"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "PARK ANAHEIM HEALTH CARE, LLC",
"organizational_subpart": "NO",
"enumeration_date": "2006-11-07",
"last_updated": "2018-05-10",
"status": "A",
"authorized_official_last_name": "FRIEDMAN",
"authorized_official_first_name": "DAVID",
"authorized_official_title_or_position": "MANAGING MEMBER",
"authorized_official_telephone_number": "213-389-6900"
},
"taxonomies": [
{
"code": "314000000X",
"taxonomy_group": "",
"desc": "Skilled Nursing Facility",
"state": "CA",
"license": "060000094",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "LTC55035G",
"state": "CA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "LTC70120F",
"state": "CA"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "PARK ANAHEIM HEALTHCARE CENTER",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "PARK ANAHEIM HEALTHCARE CENTER",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Anaheim, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2018; 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.