NPIMap

Organization Active NPI

CPH Hospital Management LLC

  • Psychiatric Hospital Unit
  • Norwalk, CA
National Provider Identifier
1952012379
Registry record updated Jul 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric Hospital UnitTaxonomy code 273R00000X
Legal business name
CPH HOSPITAL MANAGEMENT LLC
Practice address
13100 Studebaker Rd
Norwalk, CA 90650-2531
Phone
(562) 868-3751
NPI assigned
Dec 6, 2022
Organization subpart
Yes
Parent organization
CPH HOSPITAL MANAGEMENT, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 14, 2023

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

Authorized official

Name
Mark Edward Dakich
Title
Manager of Legal Affairs
Phone
(310) 356-0514

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric Hospital Unit 273R00000X Primary

Addresses

Primary practice location

13100 Studebaker Rd
Norwalk, CA 90650-2531

Mailing address

898 N Pacific Coast Hwy Ste 700
El Segundo, CA 90245-2742
Phone (310) 356-0505

Other names 1

  • Coast Plaza Hospital Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110627000128 CA Part A Provider - Hospital 0547448326 1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Norwalk, CA

Hospital certification: CCN 050771

Legal name
CPH HOSPITAL MANAGEMENT LLC
Doing business as
COAST PLAZA HOSPITAL
Certification status
Active
Provider type (POS)
Hospital – Short-term
Participating since
Aug 15, 2011
Last certification
Apr 6, 2023
Beds
117 (105 certified)
Ownership / control type
Private (for profit)
Organization structure
LLCProprietary
Incorporated
Mar 31, 2011 in NV
Enrollment address
13100 Studebaker Rd
Norwalk, CA 90650-2531
Other Hospital Practice Location
Hospital subgroups
General, Acute care, Psychiatric unit

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
Coast Plaza HospitalCCN 050771
Overall star rating
1 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
Tax ID family
CPH Hospital Management LLC2 organizations share this tax ID, including this one
Part of
CPH Hospital Management LLC

Other organizations with this tax ID 1

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

Locations

898 N Pacific Coast Hwy
Ste 700
El Segundo, CA 90245

Ownership & related parties

All disclosed owners & managing parties 15

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

NameRoleSinceShare
Dkldoi DFP Opco II LLC Organization, New York, NY LLC, Investment firm, For-profit 5% Or Greater Indirect Ownership Interest Feb 6, 2023 32.97%
DK Ldoi IV Aggregate Holdco LP Organization, New York, NY Investment firm, For-profit 5% Or Greater Indirect Ownership Interest Feb 6, 2023 32.97%
Davidson Kempner Long-Term Distressed Opportunities Fund IV L Organization, New York, NY Investment firm, For-profit 5% Or Greater Indirect Ownership Interest Feb 6, 2023 16.93%
PHS Intermediate Holdings, LLC Organization, New York, NY LLC, Investment firm, For-profit 5% Or Greater Indirect Ownership Interest Feb 6, 2023 49.9%
Davidson Kempner Long-Term Distressed Opps Intl IV Aiv LP Organization, New York, NY Investment firm, For-profit 5% Or Greater Indirect Ownership Interest Feb 6, 2023 32.97%
Avanti Hospitals LLC Organization, El Segundo, CA LLC, For-profit 5% Or Greater Direct Ownership Interest Mar 29, 2011 100%
Avanti Hospital Holdings I LLC Organization, El Segundo, CA LLC, For-profit 5% Or Greater Direct Ownership Interest Mar 29, 2011 100%
DFP Opco II LLC Organization, New York, NY LLC, Investment firm, For-profit 5% Or Greater Indirect Ownership Interest Feb 6, 2023 49.9%
Avanti Healthcare Holdings LLC Organization, El Segundo, CA LLC, For-profit 5% Or Greater Indirect Ownership Interest Mar 29, 2011 100%
Patrick Rafferty Individual Contracted Managing EmployeeCeo Jan 28, 2019
Pipeline Health System Holdings, LLC Organization, El Segundo, CA LLC, For-profit 5% Or Greater Indirect Ownership Interest Jan 28, 2019 100%
Deerfield Private Design Fund IV, LP Organization, New York, NY LLC, Investment firm, For-profit 5% Or Greater Indirect Ownership Interest Feb 6, 2023 49.9%
Brittany M Whitman Individual Corporate OfficerGeneral Counsel Feb 6, 2023
Robert L Allen Individual Corporate OfficerCeo Feb 6, 2023
DFP Opco II BT LLC Organization, New York, NY LLC, Investment firm, For-profit 5% Or Greater Indirect Ownership Interest Feb 6, 2023 16.93%

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 2

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

Affiliated clinicians 88

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

View all 88

NPI Registry JSON

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

{
    "created_epoch": "1670284800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1689292800000",
    "number": "1952012379",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "898 N PACIFIC COAST HWY STE 700",
            "city": "EL SEGUNDO",
            "state": "CA",
            "postal_code": "902452742",
            "telephone_number": "310-356-0505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13100 STUDEBAKER RD",
            "city": "NORWALK",
            "state": "CA",
            "postal_code": "906502531",
            "telephone_number": "562-868-3751"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CPH HOSPITAL MANAGEMENT LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CPH HOSPITAL MANAGEMENT, LLC",
        "enumeration_date": "2022-12-06",
        "last_updated": "2023-07-14",
        "certification_date": "2023-07-14",
        "status": "A",
        "authorized_official_last_name": "DAKICH",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "EDWARD",
        "authorized_official_title_or_position": "MANAGER OF LEGAL AFFAIRS",
        "authorized_official_telephone_number": "310-356-0514"
    },
    "taxonomies": [
        {
            "code": "273R00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Unit",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Coast Plaza Hospital",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Coast Plaza Hospital",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Norwalk, CA

Sources for this page

Verify at the official NPI Registry.