Organization Active NPI

La Mirada Post Acute LLC

  • Skilled Nursing Facility
  • La Mirada, CA
National Provider Identifier
1891420394
Registry record updated Jul 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
LA MIRADA POST ACUTE LLC
Practice address
12200 La Mirada Blvd
La Mirada, CA 90638-1306
Phone
(562) 947-8691
NPI assigned
Jul 19, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 19, 2022

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

Authorized official

Name
David Johnson
Title
Ceo
Phone
(714) 577-3880

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X Primary

Addresses

Primary practice location

12200 La Mirada Blvd
La Mirada, CA 90638-1306

Mailing address

12200 La Mirada Blvd
La Mirada, CA 90638-1306
Phone (562) 947-8691

Other names 1

  • Sunny Hills Post Acute Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20221025000615 CA Part A Provider - Skilled Nursing Facility 1951777499 Practice locations: La Mirada, CA

Skilled nursing facility certification: CCN 055737

Legal name
LA MIRADA POST ACUTE LLC
Doing business as
SUNNY HILLS POST ACUTE
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Oct 1, 1972
Last certification
Oct 31, 2024
Beds
142
Ownership / control type
Limited Liability Corporation
Organization structure
LLCProprietary
Enrollment address
12200 La Mirada Blvd
La Mirada, CA 90638-1306
Nursing home name
SUNNY HILLS POST ACUTE
Affiliated entity
DAVID JOHNSON

Care Compare: Nursing home

Medicare Care Compare
Listed as
Sunny Hills Post AcuteCCN 055737
Overall star rating
2 of 5
Health inspections
1 of 5
Staffing
3 of 5
Quality measures
5 of 5
Type
Medicare and Medicaid
Ownership
For profit - Limited Liability company
Certified
Oct 1, 1972
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
142127.5 residents per day on average
Chain
David Johnson48 facilities in the chain
Penalties (3 years)
1Fines totaling $16,149

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
05D0709904Sunny Hills Post Acute12200 La Mirada Blvd, La Mirada, CA 90638Certificate of waiverAug 31, 2026

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 12

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

NameRoleSinceShare
La Mirada Post Acute LLC Organization, Brea, CA Created for acquisition, LLC 5% Or Greater Direct Ownership Interest Aug 16, 2022 100%
Josephine Drew Individual Operational/Managerial Control Nov 19, 2024
VBN New York LLC Organization, New York, NY Investment firm, Financial institution Adp of the SNF Aug 16, 2022
David a Johnson Individual 5% Or Greater Direct Ownership InterestOwner and Manager Aug 16, 2022 50%
Operational/Managerial Control Apr 1, 2022
Micheal D Oxford Individual Operational/Managerial Control Jan 3, 2022
Adp of the SNF Jan 3, 2022
Frank a Johnson Individual 5% Or Greater Direct Ownership InterestOwner Aug 16, 2022 50%
Operational/Managerial Control Apr 1, 2022
Stacy Brown Individual Operational/Managerial Control Jul 28, 2023
Adp of the SNF Jan 31, 2026
Joshua Kochek Individual Corporate OfficerPresident Apr 1, 2022
Operational/Managerial Control Apr 1, 2022
Sun Meridian Management Services LLC Organization, Brea, CA LLC Adp of the SNF Mar 22, 2021
Adrian Dehghanmanesh Individual Corporate OfficerSecretary; Treasurer Aug 16, 2022
Mary Farrales Individual Corporate OfficerController Jan 1, 2023
La Mirada Property Holdings, LLC Organization, Skokie, IL LLC Adp of the SNF Aug 16, 2022

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": "1658188800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658188800000",
    "number": "1891420394",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12200 LA MIRADA BLVD",
            "city": "LA MIRADA",
            "state": "CA",
            "postal_code": "906381306",
            "telephone_number": "562-947-8691"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12200 LA MIRADA BLVD",
            "city": "LA MIRADA",
            "state": "CA",
            "postal_code": "906381306",
            "telephone_number": "562-947-8691"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LA MIRADA POST ACUTE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-07-19",
        "last_updated": "2022-07-19",
        "certification_date": "2022-07-19",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "714-577-3880"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sunny Hills Post Acute",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in La Mirada, CA

Sources for this page

Verify at the official NPI Registry.