Organization Active NPI

1495 Cameron Avenue, LLC

  • Skilled Nursing Facility
  • West Covina, CA
National Provider Identifier
1912134263
Registry record updated Dec 5, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
1495 CAMERON AVENUE, LLC
Practice address
1495 W Cameron Ave
West Covina, CA 91790-2710
Phone
(626) 962-4461
Fax
(626) 960-8457
NPI assigned
Jun 14, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 5, 2013

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

Authorized official

Name
Matthew Karp
Title
Managing Member
Phone
(818) 821-3897

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X Primary

Addresses

Primary practice location

1495 W Cameron Ave
West Covina, CA 91790-2710

Mailing address

1495 W Cameron Ave
West Covina, CA 91790-2710
Phone (626) 962-4461

Other names 1

  • West Haven Healthcare Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090824000177 CA Part A Provider - Skilled Nursing Facility 6002960200 Practice locations: West Covina, CA

Skilled nursing facility certification: CCN 056228

Legal name
1495 CAMERON AVENUE, LLC
Doing business as
WEST HAVEN HEALTHCARE
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Jul 17, 1970
Last certification
Jan 24, 2025
Beds
99
Ownership / control type
Limited Liability Corporation
Organization structure
LLCProprietary
Incorporated
Mar 20, 2009 in CA
Enrollment address
1495 W Cameron Ave
West Covina, CA 91790-2710
Nursing home name
WEST HAVEN HEALTHCARE
Affiliated entity
AARON MAYER

Care Compare: Nursing home

Medicare Care Compare
Listed as
West Haven HealthcareCCN 056228
Overall star rating
4 of 5
Health inspections
3 of 5
Staffing
3 of 5
Quality measures
5 of 5
Type
Medicare and Medicaid
Ownership
For profit - Limited Liability company
Certified
Jul 17, 1970
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
9976.9 residents per day on average
Chain
Aaron Mayer7 facilities in the chain

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
05D0901507West Haven Healthcare1495 W Cameron Ave, West Covina, CA 91790Certificate of waiverJul 13, 2026

National Provider Directory

National Provider Directory

Locations

3452 E Foothill Blvd
Ste 710
Pasadena, CA 91107

Ownership & related parties

All disclosed owners & managing parties 20

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

NameRoleSinceShare
Aviva Colman Individual Indirect Ownership Interest Jun 30, 2023 4.63%
Talia Rokowsky Individual Indirect Ownership Interest Jun 30, 2023 4.63%
Oliver M Solomon Individual Operational/Managerial Control Jun 22, 2022
Adp of the SNF Jun 22, 2022
ZM Family Holdings LLC Organization, Valley Village, CA LLC, Holding company, For-profit Direct Ownership Interest Jun 30, 2023 4.63%
Atr Family Holdings LLC Organization, Valley Village, CA LLC, Holding company, For-profit Direct Ownership Interest Jun 30, 2023 4.63%
Ahm Family Holdings LLC Organization, Valley Village, CA LLC, Holding company, For-profit Direct Ownership Interest Jun 30, 2023 4.63%
Menlo Trust U/T/D February 22, 1983 Organization, Los Angeles, CA For-profit Adp of the SNF Sep 22, 2003
Isaac Deutsch Individual 5% Or Greater Indirect Ownership Interest May 11, 2023 72.23%
Corporate OfficerTrustee/Manager Jun 30, 2023 100%
Asm Family Holdings LLC Organization, Valley Village, CA LLC, Holding company, For-profit Direct Ownership Interest Jun 30, 2023 4.63%
Amuche Obinwa Individual Operational/Managerial Control Jan 2, 2024
Adp of the SNF Jan 2, 2024
Akiva Mayer Individual Indirect Ownership Interest Jun 30, 2023 4.63%
MM2 Business Services, LLLP Organization, Los Angeles, CA LLC, Management services company, For-profit Adp of the SNF Aug 8, 2021
Amm Family Holdings LLC Organization, Valley Village, CA LLC, Holding company, For-profit Direct Ownership Interest Jun 30, 2023 4.63%
AMC Family Holding LLC Organization, Valley Village, CA LLC, Holding company, For-profit Direct Ownership Interest Jun 30, 2023 4.63%
Abraham Mayer Individual Indirect Ownership Interest Jun 30, 2023 4.63%
Individual Adp of the SNF Aug 1, 2024
Deutsch 2016 Grat Organization, Pasadena, CA For-profit 5% Or Greater Direct Ownership Interest May 11, 2023 72.23%
Zachary Mayer Individual Indirect Ownership Interest Jun 30, 2023 4.63%
Miracle Mile Properties LP Organization, Los Angeles, CA For-profit Adp of the SNF Aug 1, 2024
Aaron Mayer Individual Indirect Ownership Interest Jun 30, 2023 4.63%

Owners & managing parties with NPI records 1

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

Facilities with the same owner 3

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

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Affiliated clinicians 4

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": "1244937600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1386201600000",
    "number": "1912134263",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1495 W CAMERON AVE",
            "city": "WEST COVINA",
            "state": "CA",
            "postal_code": "917902710",
            "telephone_number": "626-962-4461",
            "fax_number": "626-960-8457"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1495 W CAMERON AVE",
            "city": "WEST COVINA",
            "state": "CA",
            "postal_code": "917902710",
            "telephone_number": "626-962-4461",
            "fax_number": "626-960-8457"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "1495 CAMERON AVENUE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-06-14",
        "last_updated": "2013-12-05",
        "status": "A",
        "authorized_official_last_name": "KARP",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "818-821-3897"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "West Haven Healthcare",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in West Covina, CA

Sources for this page

Verify at the official NPI Registry.