Active NPI
1495 Cameron Avenue, LLC
- Skilled Nursing Facility
- West Covina, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Skilled Nursing Facility
- 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
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) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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
- LLC
- 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 Healthcare
- Overall star rating
- Health inspections
- Staffing
- Quality measures
- Type
- Medicare and Medicaid
- Ownership
- For profit - Limited Liability company
- Certified
- Jul 17, 1970
- Medicare certification status
- Active
- Certified beds
- 99
- Chain
- Aaron Mayer
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 |
|---|---|---|---|
| 05D0901507 | West Haven Healthcare | Certificate of waiver | Jul 13, 2026 |
National Provider Directory
National Provider DirectoryLocations
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.
| Name | Role | Since | Share |
|---|---|---|---|
| Aviva Colman | Indirect Ownership Interest | Jun 30, 2023 | 4.63% |
| Talia Rokowsky | Indirect Ownership Interest | Jun 30, 2023 | 4.63% |
| Oliver M Solomon | Operational/Managerial Control | Jun 22, 2022 | |
| Adp of the SNF | Jun 22, 2022 | ||
| ZM Family Holdings LLC | Direct Ownership Interest | Jun 30, 2023 | 4.63% |
| Atr Family Holdings LLC | Direct Ownership Interest | Jun 30, 2023 | 4.63% |
| Ahm Family Holdings LLC | Direct Ownership Interest | Jun 30, 2023 | 4.63% |
| Menlo Trust U/T/D February 22, 1983 | Adp of the SNF | Sep 22, 2003 | |
| Isaac Deutsch | 5% Or Greater Indirect Ownership Interest | May 11, 2023 | 72.23% |
| Corporate Officer | Jun 30, 2023 | 100% | |
| Asm Family Holdings LLC | Direct Ownership Interest | Jun 30, 2023 | 4.63% |
| Amuche Obinwa | Operational/Managerial Control | Jan 2, 2024 | |
| Adp of the SNF | Jan 2, 2024 | ||
| Akiva Mayer | Indirect Ownership Interest | Jun 30, 2023 | 4.63% |
| MM2 Business Services, LLLP | Adp of the SNF | Aug 8, 2021 | |
| Amm Family Holdings LLC | Direct Ownership Interest | Jun 30, 2023 | 4.63% |
| AMC Family Holding LLC | Direct Ownership Interest | Jun 30, 2023 | 4.63% |
| Abraham Mayer | Indirect Ownership Interest | Jun 30, 2023 | 4.63% |
| Adp of the SNF | Aug 1, 2024 | ||
| Deutsch 2016 Grat | 5% Or Greater Direct Ownership Interest | May 11, 2023 | 72.23% |
| Zachary Mayer | Indirect Ownership Interest | Jun 30, 2023 | 4.63% |
| Miracle Mile Properties LP | Adp of the SNF | Aug 1, 2024 | |
| Aaron Mayer | 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.
-
- Internal Medicine Physician
- Glendora, CA
- NPI 1255403085
Adp of the SNF, Operational/Managerial Control
Facilities with the same owner 3
Facilities that share an organizational owner with 5% or greater ownership or operational control.
-
- Skilled Nursing Facility
- Pasadena, CA
- NPI 1457719783
Deutsch 2016 Grat
-
- Skilled Nursing Facility
- Los Angeles, CA
- NPI 1184871659
Deutsch 2016 Grat
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
- Glendora, CA
- NPI 1255403085
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2013; 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.