NPIMap

Organization Active NPI

Prime Healthcare Paradise Valley LLC

Doing business as Paradise Valley Hospital

  • Rehabilitation Hospital Unit
  • National City, CA
National Provider Identifier
1972679694
Registry record updated Apr 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation Hospital UnitTaxonomy code 273Y00000X
License
090000086 Issued in CA
Legal business name
PRIME HEALTHCARE PARADISE VALLEY LLC
Doing business as
Paradise Valley Hospital
Practice address
2400 E 4TH St
National City, CA 91950-2026
Phone
(619) 470-4321
NPI assigned
Nov 27, 2006
Last updated
Apr 14, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 14, 2023

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

Authorized official

Name
Christopher Doan
Title
Managing Associate General Counsel
Phone
(310) 259-4706

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation Hospital Unit 273Y00000X
Rehabilitation Hospital Unit 273Y00000X 090000086 CA Primary

Addresses

Primary practice location

2400 E 4TH St
National City, CA 91950-2026

Mailing address

3480 E Guasti Rd
Ontario, CA 91761-7684
Phone (909) 235-4400

Other names 1

  • Paradise Valley Hospital Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070130000727 CA Part A Provider - Hospital 4587664412 Practice locations: National City, CA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1972679694. Details of each certification follow.

Hospital certification: CCN 05T024

Legal name
PRIME HEALTHCARE PARADISE VALLEY LLC
Doing business as
PARADISE VALLEY HOSPITAL
Organization structure
LLCProprietary
Incorporated
Nov 6, 2006 in DE
Enrollment address
2400 E Fourth St
National City, CA 91950-2026
Other Hospital Practice Location
Hospital subgroups
Acute care, Rehabilitation

Facilities connected through Provider of Services related, parent or unit certification numbers.

Other NPIs with the same Medicare PAC ID 2

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Care Compare: Inpatient rehabilitation facility

Medicare Care Compare
Listed as
South Bay Rehabilitation CtrCCN 05T024 · All quality measures
Ownership
For profit
Certified
Jan 1, 1989

National Provider Directory

National Provider Directory
Tax ID family
Prime Healthcare Inc8 organizations share this tax ID, including this one

Other organizations with this tax ID 7

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

Ownership & related parties

All disclosed owners & managing parties 7

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

NameRoleSinceShare
Prime Healthcare Services, Inc Organization, Ontario, CA Corporation, For-profit 5% Or Greater Direct Ownership Interest Mar 1, 2007 100%
Other Mar 1, 2007 100%
Gemma Rama B Individual Corporate DirectorDirector Jan 1, 2013
Luis Leon Individual Corporate OfficerCorporate Chief Executive Officer Mar 4, 2012
Neerav Jadeja Individual Corporate OfficerChief Executive Officer Jun 1, 2020
Corporate DirectorDirector Jun 1, 2020
W-2 Managing EmployeeChief Executive Officer Jun 1, 2020
Steven Aleman Individual Corporate OfficerChief Financial Officer Jun 1, 2020
Christopher Doan Individual Corporate OfficerChief Compliance Counsel Apr 24, 2017
Prime Healthcare Holdings Inc Organization, Ontario, CA Corporation, Holding company 5% Or Greater Indirect Ownership Interest Apr 21, 2010 100%

Facilities with the same owner 77

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

View all 77

Practitioners & affiliated clinicians

Affiliated clinicians 2

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": "1164585600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1681430400000",
    "number": "1972679694",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3480 E GUASTI RD",
            "city": "ONTARIO",
            "state": "CA",
            "postal_code": "917617684",
            "telephone_number": "909-235-4400",
            "fax_number": "909-235-4316"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2400 E 4TH ST",
            "city": "NATIONAL CITY",
            "state": "CA",
            "postal_code": "919502026",
            "telephone_number": "619-470-4321"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIME HEALTHCARE PARADISE VALLEY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-27",
        "last_updated": "2023-04-14",
        "certification_date": "2023-04-14",
        "status": "A",
        "authorized_official_last_name": "DOAN",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_title_or_position": "MANAGING ASSOCIATE GENERAL COUNSEL",
        "authorized_official_telephone_number": "310-259-4706"
    },
    "taxonomies": [
        {
            "code": "273Y00000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Unit",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "273Y00000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Unit",
            "state": "CA",
            "license": "090000086",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Paradise Valley Hospital",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Paradise Valley Hospital",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in National City, CA

Sources for this page

Verify at the official NPI Registry.