NPIMap

Organization Active NPI

Anaheim Community Hospital, LLC

  • General Acute Care Hospital
  • Anaheim, CA
National Provider Identifier
1902479447
Registry record updated Jul 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Acute Care HospitalTaxonomy code 282N00000X
Legal business name
ANAHEIM COMMUNITY HOSPITAL, LLC
Practice address
3350 W Ball Rd
Anaheim, CA 92804-3710
Phone
(248) 905-5091
NPI assigned
Jul 22, 2021
Last updated
Jul 3, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 3, 2023

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

Authorized official

Name
Hana Attar
Title
VP
Phone
(248) 839-5378

Specialties & licenses 1

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

Addresses

Primary practice location

3350 W Ball Rd
Anaheim, CA 92804-3710

Mailing address

3350 W Ball Rd
Anaheim, CA 92804-3710

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220907000896 CA Part A Provider - Hospital 5193109320 Practice locations: Anaheim, CA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1902479447. Details of each certification follow.

Hospital certification: CCN 050854

Legal name
ANAHEIM COMMUNITY HOSPITAL, LLC
Certification status
Active
Provider type (POS)
Hospital – Short-term
Participating since
Feb 3, 2023
Last certification
Feb 3, 2023
Beds
98
Ownership / control type
Private (for profit)
Organization structure
LLCProprietary
Incorporated
Dec 22, 2014 in CA
Enrollment address
3350 W Ball Rd
Anaheim, CA 92804-3710
Main/Primary Hospital Location
Hospital subgroups
General, Acute care

Care Compare: Hospital

Medicare Care Compare
Listed as
Anaheim Community Hospital, LLCCCN 050854 · All quality measures
Type
Acute Care Hospitals
Ownership
Proprietary
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
No

National Provider Directory

National Provider Directory
Tax ID family
Anaheim Community Hospital LLC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

Ownership & related parties

All disclosed owners & managing parties 5

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

NameRoleSinceShare
Signature Healthcare Services, LLC Organization, Troy, MI LLC, Management services company, Holding company, For-profit 5% Or Greater Direct Ownership Interest Dec 22, 2014 100%
Phillip Franks Individual Corporate OfficerCeo Dec 7, 2020 100%
Operational/Managerial ControlCeo Dec 7, 2020 100%
Glenn Raup Individual Corporate OfficerCoo and Cno Sep 27, 2021 50%
W-2 Managing EmployeeCoo and Cno Sep 27, 2021 50%
Operational/Managerial ControlCoo and Cno Sep 27, 2021 50%
Kurt Broten Individual Corporate OfficerCfo Jul 1, 2021 50%
W-2 Managing EmployeeCfo Jul 1, 2021 50%
Operational/Managerial ControlCfo Jul 1, 2021 50%
Soon Kim Individual 5% Or Greater Indirect Ownership Interest Dec 22, 2014 100%

Facilities with the same owner 16

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

View all 16

Practitioners & affiliated clinicians

Affiliated clinicians 37

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

View all 37

NPI Registry JSON

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

{
    "created_epoch": "1626912000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1688342400000",
    "number": "1902479447",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3350 W BALL RD",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928043710"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3350 W BALL RD",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928043710",
            "telephone_number": "248-905-5091"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANAHEIM COMMUNITY HOSPITAL, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-07-22",
        "last_updated": "2023-07-03",
        "certification_date": "2023-07-03",
        "status": "A",
        "authorized_official_last_name": "ATTAR",
        "authorized_official_first_name": "HANA",
        "authorized_official_title_or_position": "VP",
        "authorized_official_telephone_number": "248-839-5378"
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Anaheim, CA

Sources for this page

Verify at the official NPI Registry.