NPIMap

Organization Active NPI

Prime Healthcare Anaheim, LLC

Doing business as West Anaheim Medical Center

  • General Acute Care Hospital
  • Anaheim, CA
National Provider Identifier
1871501916
Registry record updated Feb 25, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Acute Care HospitalTaxonomy code 282N00000X
License
060000182 Issued in CA
Legal business name
PRIME HEALTHCARE ANAHEIM, LLC
Doing business as
West Anaheim Medical Center
Practice address
3033 W Orange Ave
Anaheim, CA 92804-3156
Phone
(714) 827-3000
NPI assigned
Aug 4, 2006
Last updated
Feb 25, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 25, 2014

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

Authorized official

Name
Troy A. Schell
Title
Secretary / General Counsel
Phone
(909) 235-4327

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Acute Care Hospital 282N00000X 060000182 CA Primary

Addresses

Primary practice location

3033 W Orange Ave
Anaheim, CA 92804-3156

Mailing address

3300 E Guasti Rd
3Rd Floor
Ontario, CA 91761-8655
Phone (909) 235-4400

Other names 1

  • West Anaheim Medical Center Doing business as

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20061006000447 CA Part A Provider - Hospital 9335145721 Practice locations: Anaheim, CA
O20070802000472 CA Part A Provider - Hospital 9335145721 1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Anaheim, CA

NPI to CCN mapping 2

The Medicare certification numbers (CCNs) connected to NPI 1871501916. Details of each certification follow.

Hospital certification: CCN 050426

Legal name
PRIME HEALTHCARE ANAHEIM LLC
Doing business as
WEST ANAHEIM MEDICAL CENTER
Certification status
Active
Provider type (POS)
Hospital – Short-term
Participating since
Oct 10, 1969
Last certification
Nov 17, 1983
Beds
219
Ownership / control type
Private (for profit)
Most recent change of ownership
Feb 1, 1999 (1 total)
Organization structure
LLCProprietary
Incorporated
Jul 21, 2006 in DE
Enrollment address
3033 West Orange Ave
Anaheim, CA 92804-3156
Other Hospital Practice Location
Hospital subgroups
Acute care

Hospital certification: CCN 05S426

Legal name
PRIME HEALTHCARE ANAHEIM LLC
Doing business as
WEST ANAHEIM MEDICAL CENTER
Organization structure
LLCProprietary
Incorporated
Jul 21, 2006 in DE
Enrollment address
3033 W Orange Ave
Anaheim, CA 92804-3156
Hospital Psychiatric Unit
Hospital subgroups
Acute care, Psychiatric unit

Facilities connected through Provider of Services related, parent or unit certification numbers.

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 1

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

Care Compare: Hospital

Medicare Care Compare
Listed as
West Anaheim Medical CenterCCN 050426 · All quality measures
Overall star rating
2 of 5
Type
Acute Care Hospitals
Ownership
Proprietary
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

National Provider Directory

National Provider Directory

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

Ownership & related parties

All disclosed owners & managing parties 6

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

NameRoleSinceShare
Prime Healthcare Services, Inc Organization, Ontario, CA Corporation 5% Or Greater Direct Ownership Interest Oct 1, 2006 100%
Other Oct 1, 2006
Other Oct 1, 2006 100%
Luis Leon Individual Corporate OfficerChief Executive Officer Jun 1, 2020
Ayman Mousa Individual Corporate OfficerChief Executive Officer Jul 12, 2021
Corporate DirectorChairman of the Board Jul 12, 2021
W-2 Managing EmployeeChief Executive Officer Jul 12, 2021
Corporate OfficerChief Executive Officer Jul 1, 2021
Corporate DirectorDirector Jul 1, 2021
W-2 Managing EmployeeChief Executive Officer Jul 1, 2021
Steven Aleman Individual Corporate OfficerChief Financial Officer Jun 1, 2020
Christopher Doan Individual Corporate OfficerManaging Associate General Counsel Nov 1, 2019
Corporate OfficerManaging Associate General Counsel Jun 1, 2020
Prime Healthcare Holdings Inc Organization, Ontario, CA Corporation 5% Or Greater Indirect Ownership Interest Apr 21, 2010 100%

Facilities with the same owner 77

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

View all 77

Practitioners & affiliated clinicians

Affiliated clinicians 115

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 115

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1154649600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1393286400000",
    "number": "1871501916",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3300 E GUASTI RD",
            "address_2": "3RD FLOOR",
            "city": "ONTARIO",
            "state": "CA",
            "postal_code": "917618655",
            "telephone_number": "909-235-4400",
            "fax_number": "909-235-4419"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3033 W ORANGE AVE",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928043156",
            "telephone_number": "714-827-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIME HEALTHCARE ANAHEIM, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-04",
        "last_updated": "2014-02-25",
        "status": "A",
        "authorized_official_last_name": "SCHELL",
        "authorized_official_first_name": "TROY",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "SECRETARY / GENERAL COUNSEL",
        "authorized_official_telephone_number": "909-235-4327"
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "CA",
            "license": "060000182",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "West Anaheim Medical Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Anaheim, CA

Sources for this page

Verify at the official NPI Registry.