Cross-source identifiers
Every current identifier attachment, with the link method and confidence carried verbatim — deterministic links are 1.000; probabilistic links surface their real matcher confidence, never rounded up.
| Scheme | Value | Source table | Link method | Confidence | Since | Provenance |
|---|---|---|---|---|---|---|
| npi | 1881681559 | nppes_providers | deterministic_pk | 1.000 | 2026-06-10 | evidencerecorded: 2026-06-10 methodology: entity-graph/v1 evidence: {"rule":"D-NPI","source_pk":"1881681559","entity_type_code":"2"} |
| pac_id | 3779486071 | pecos_providers | exact_npi_in_pecos | 1.000 | 2026-06-16 | evidencerecorded: 2026-06-16 methodology: entity-graph/v1 evidence: {"npi":"1881681559","rule":"D-PECOS","enrlmt_id":"O20040202000386","pecos_asct_cntl_id":"3779486071"} |
| pecos_enrlmt_id | O20040202000386 | pecos_providers | exact_npi_in_pecos | 1.000 | 2026-06-16 | evidencerecorded: 2026-06-16 methodology: entity-graph/v1 evidence: {"npi":"1881681559","rule":"D-PECOS","enrlmt_id":"O20040202000386"} |
Graph edges
One-hop relationships — ownership, chain membership, operation — each backed by a federal source row.
| Relationship | Entity | Confidence | Source table | Provenance |
|---|---|---|---|---|
| ← owns | JULIE PHAM | 1.000 | snf_all_owners | evidencerecorded: 2026-06-16 methodology: entity-graph/v1 attributes: {"role_code":"40","association_date":"03/16/2000","percentage_ownership":null} evidence: {"rule":"D-OWNER","owner_pac":"0648412486","source_pk":14546,"type_owner":"I","enrollment_id":"O20040202000386","role_code_owner":"40","role_text_owner":"CORPORATE OFFICER","dst_resolved_via":"pecos_enrlmt_id","percentage_ownership_raw":null,"enrollment_organization_name":"1130 W LA PALMA AVE INC"} |
| ← owns | JANET MANDELBAUM | 1.000 | snf_all_owners | evidencerecorded: 2026-06-16 methodology: entity-graph/v1 attributes: {"role_code":"40","association_date":"01/02/2019","percentage_ownership":50} evidence: {"rule":"D-OWNER","owner_pac":"0941341648","source_pk":14549,"type_owner":"I","enrollment_id":"O20040202000386","role_code_owner":"40","role_text_owner":"CORPORATE OFFICER","dst_resolved_via":"pecos_enrlmt_id","percentage_ownership_raw":50,"enrollment_organization_name":"1130 W LA PALMA AVE INC"} |
| ← owns | JOYLOURDES TORRES | 1.000 | snf_all_owners | evidencerecorded: 2026-06-16 methodology: entity-graph/v1 attributes: {"role_code":"43","association_date":"10/09/2023","percentage_ownership":null} evidence: {"rule":"D-OWNER","owner_pac":"1850896374","source_pk":14551,"type_owner":"I","enrollment_id":"O20040202000386","role_code_owner":"43","role_text_owner":"OPERATIONAL/MANAGERIAL CONTROL","dst_resolved_via":"pecos_enrlmt_id","percentage_ownership_raw":null,"enrollment_organization_name":"1130 W LA PALMA AVE INC"} |
| ← owns | HANSEN (OR) | 1.000 | snf_all_owners | evidencerecorded: 2026-06-16 methodology: entity-graph/v1 attributes: {"role_code":"72","association_date":"01/01/2023","percentage_ownership":null} evidence: {"rule":"D-OWNER","owner_pac":"1951789437","source_pk":14553,"type_owner":"O","enrollment_id":"O20040202000386","role_code_owner":"72","role_text_owner":"ADP OF THE SNF","dst_resolved_via":"pecos_enrlmt_id","percentage_ownership_raw":null,"enrollment_organization_name":"1130 W LA PALMA AVE INC"} |
| ← owns | OWNER PAC 2860997384 (CA) | 1.000 | snf_all_owners | evidencerecorded: 2026-06-16 methodology: entity-graph/v1 attributes: {"role_code":"72","association_date":"01/01/2023","percentage_ownership":null} evidence: {"rule":"D-OWNER","owner_pac":"2860997384","source_pk":14554,"type_owner":"O","enrollment_id":"O20040202000386","role_code_owner":"72","role_text_owner":"ADP OF THE SNF","dst_resolved_via":"pecos_enrlmt_id","percentage_ownership_raw":null,"enrollment_organization_name":"1130 W LA PALMA AVE INC"} |
| ← owns | LIZETTE CORTEZ | 1.000 | snf_all_owners | evidencerecorded: 2026-06-16 methodology: entity-graph/v1 attributes: {"role_code":"43","association_date":"02/02/2004","percentage_ownership":null} evidence: {"rule":"D-OWNER","owner_pac":"3577068097","source_pk":14555,"type_owner":"I","enrollment_id":"O20040202000386","role_code_owner":"43","role_text_owner":"OPERATIONAL/MANAGERIAL CONTROL","dst_resolved_via":"pecos_enrlmt_id","percentage_ownership_raw":null,"enrollment_organization_name":"1130 W LA PALMA AVE INC"} |
| ← owns | DANILO GONZALEZ | 1.000 | snf_all_owners | evidencerecorded: 2026-06-16 methodology: entity-graph/v1 attributes: {"role_code":"43","association_date":"05/03/2021","percentage_ownership":null} evidence: {"rule":"D-OWNER","owner_pac":"4486159902","source_pk":14557,"type_owner":"I","enrollment_id":"O20040202000386","role_code_owner":"43","role_text_owner":"OPERATIONAL/MANAGERIAL CONTROL","dst_resolved_via":"pecos_enrlmt_id","percentage_ownership_raw":null,"enrollment_organization_name":"1130 W LA PALMA AVE INC"} |
| ← owns | SKILLSERVE INC (CA) | 1.000 | snf_all_owners | evidencerecorded: 2026-06-16 methodology: entity-graph/v1 attributes: {"role_code":"72","association_date":"01/01/2023","percentage_ownership":null} evidence: {"rule":"D-OWNER","owner_pac":"4587939145","source_pk":14559,"type_owner":"O","enrollment_id":"O20040202000386","role_code_owner":"72","role_text_owner":"ADP OF THE SNF","dst_resolved_via":"pecos_enrlmt_id","percentage_ownership_raw":null,"enrollment_organization_name":"1130 W LA PALMA AVE INC"} |
| ← owns | MARIA CASTRO-GARCIA | 1.000 | snf_all_owners | evidencerecorded: 2026-06-16 methodology: entity-graph/v1 attributes: {"role_code":"40","association_date":"11/06/2019","percentage_ownership":null} evidence: {"rule":"D-OWNER","owner_pac":"4688061286","source_pk":14560,"type_owner":"I","enrollment_id":"O20040202000386","role_code_owner":"40","role_text_owner":"CORPORATE OFFICER","dst_resolved_via":"pecos_enrlmt_id","percentage_ownership_raw":null,"enrollment_organization_name":"1130 W LA PALMA AVE INC"} |
| ← owns | THE BENTZION MANDELBAUM 2021 IRREVOCABLE GIFT TRUST NO. 2 (CA) | 1.000 | snf_all_owners | evidencerecorded: 2026-06-16 methodology: entity-graph/v1 attributes: {"role_code":"34","association_date":"01/01/2023","percentage_ownership":50} evidence: {"rule":"D-OWNER","owner_pac":"4789079807","source_pk":14562,"type_owner":"O","enrollment_id":"O20040202000386","role_code_owner":"34","role_text_owner":"5% OR GREATER DIRECT OWNERSHIP INTEREST","dst_resolved_via":"pecos_enrlmt_id","percentage_ownership_raw":50,"enrollment_organization_name":"1130 W LA PALMA AVE INC"} |
| ← owns | MARY MARTILLANO | 1.000 | snf_all_owners | evidencerecorded: 2026-06-16 methodology: entity-graph/v1 attributes: {"role_code":"43","association_date":"11/29/2010","percentage_ownership":null} evidence: {"rule":"D-OWNER","owner_pac":"5395240816","source_pk":14563,"type_owner":"I","enrollment_id":"O20040202000386","role_code_owner":"43","role_text_owner":"OPERATIONAL/MANAGERIAL CONTROL","dst_resolved_via":"pecos_enrlmt_id","percentage_ownership_raw":null,"enrollment_organization_name":"1130 W LA PALMA AVE INC"} |
| ← owns | SIMCHA AND JANET MANDELBAUM FAMILY TRUST (CA) | 1.000 | snf_all_owners | evidencerecorded: 2026-06-16 methodology: entity-graph/v1 attributes: {"role_code":"34","association_date":"01/01/2023","percentage_ownership":20} evidence: {"rule":"D-OWNER","owner_pac":"6204292790","source_pk":14565,"type_owner":"O","enrollment_id":"O20040202000386","role_code_owner":"34","role_text_owner":"5% OR GREATER DIRECT OWNERSHIP INTEREST","dst_resolved_via":"pecos_enrlmt_id","percentage_ownership_raw":20,"enrollment_organization_name":"1130 W LA PALMA AVE INC"} |
| ← owns | GERARDO PEREZ | 1.000 | snf_all_owners | evidencerecorded: 2026-06-16 methodology: entity-graph/v1 attributes: {"role_code":"43","association_date":"05/07/2024","percentage_ownership":null} evidence: {"rule":"D-OWNER","owner_pac":"6204331721","source_pk":14566,"type_owner":"I","enrollment_id":"O20040202000386","role_code_owner":"43","role_text_owner":"OPERATIONAL/MANAGERIAL CONTROL","dst_resolved_via":"pecos_enrlmt_id","percentage_ownership_raw":null,"enrollment_organization_name":"1130 W LA PALMA AVE INC"} |
| ← owns | REZA TALEBI DOLOUEI (CA) | 1.000 | snf_all_owners | evidencerecorded: 2026-06-16 methodology: entity-graph/v1 attributes: {"role_code":"43","association_date":"12/01/2023","percentage_ownership":null} evidence: {"rule":"D-OWNER","owner_pac":"6507167053","source_pk":14568,"type_owner":"I","enrollment_id":"O20040202000386","role_code_owner":"43","role_text_owner":"OPERATIONAL/MANAGERIAL CONTROL","dst_resolved_via":"pecos_enrlmt_id","percentage_ownership_raw":null,"enrollment_organization_name":"1130 W LA PALMA AVE INC"} |
| ← owns | THE SIMCHA MANDELBAUM 2021 IRREVOCABLE GIFT TRUST NO. 2 (CA) | 1.000 | snf_all_owners | evidencerecorded: 2026-06-16 methodology: entity-graph/v1 attributes: {"role_code":"34","association_date":"01/01/2023","percentage_ownership":14} evidence: {"rule":"D-OWNER","owner_pac":"7012373509","source_pk":14570,"type_owner":"O","enrollment_id":"O20040202000386","role_code_owner":"34","role_text_owner":"5% OR GREATER DIRECT OWNERSHIP INTEREST","dst_resolved_via":"pecos_enrlmt_id","percentage_ownership_raw":14,"enrollment_organization_name":"1130 W LA PALMA AVE INC"} |
| ← owns | KYUNG-MY LEE | 1.000 | snf_all_owners | evidencerecorded: 2026-06-16 methodology: entity-graph/v1 attributes: {"role_code":"43","association_date":"04/01/2024","percentage_ownership":null} evidence: {"rule":"D-OWNER","owner_pac":"7012412539","source_pk":14571,"type_owner":"I","enrollment_id":"O20040202000386","role_code_owner":"43","role_text_owner":"OPERATIONAL/MANAGERIAL CONTROL","dst_resolved_via":"pecos_enrlmt_id","percentage_ownership_raw":null,"enrollment_organization_name":"1130 W LA PALMA AVE INC"} |
| ← owns | THE JANET MANDELBAUM 2021 IRREVOCABLE GIFT TRUST NO 2 (CA) | 1.000 | snf_all_owners | evidencerecorded: 2026-06-16 methodology: entity-graph/v1 attributes: {"role_code":"34","association_date":"01/01/2023","percentage_ownership":16} evidence: {"rule":"D-OWNER","owner_pac":"8224423348","source_pk":14573,"type_owner":"O","enrollment_id":"O20040202000386","role_code_owner":"34","role_text_owner":"5% OR GREATER DIRECT OWNERSHIP INTEREST","dst_resolved_via":"pecos_enrlmt_id","percentage_ownership_raw":16,"enrollment_organization_name":"1130 W LA PALMA AVE INC"} |
| ← owns | CLINTON WILLIAMS | 1.000 | snf_all_owners | evidencerecorded: 2026-06-16 methodology: entity-graph/v1 attributes: {"role_code":"40","association_date":"05/04/2010","percentage_ownership":null} evidence: {"rule":"D-OWNER","owner_pac":"9931616521","source_pk":14574,"type_owner":"I","enrollment_id":"O20040202000386","role_code_owner":"40","role_text_owner":"CORPORATE OFFICER","dst_resolved_via":"pecos_enrlmt_id","percentage_ownership_raw":null,"enrollment_organization_name":"1130 W LA PALMA AVE INC"} |
Current record
Current claims returned for this entity, grouped by provenance subject. The table exposes the source identifier recorded for each claim.
org · 1881681559 JSON
| Metric | Value | Asserted | Source |
|---|---|---|---|
| dba_name | <UNAVAIL> | 2026-06-10 | Centers for Medicare & Medicaid ServicesNPPES NPI Registry (individuals) 202602 publisher: Centers for Medicare & Medicaid Services retrieved: 2026-06-10 sha256: 8b5267e250fd4df6… claim API: JSON |
| enumeration_date | 2005-09-28 | 2026-06-10 | Centers for Medicare & Medicaid ServicesNPPES NPI Registry (individuals) 202602 publisher: Centers for Medicare & Medicaid Services retrieved: 2026-06-10 sha256: 8b5267e250fd4df6… claim API: JSON |
| legal_business_name | 1130 W LA PALMA AVE INC | 2026-06-10 | Centers for Medicare & Medicaid ServicesNPPES NPI Registry (individuals) 202602 publisher: Centers for Medicare & Medicaid Services retrieved: 2026-06-10 sha256: 8b5267e250fd4df6… claim API: JSON |
| practice_state | CA | 2026-06-10 | Centers for Medicare & Medicaid ServicesNPPES NPI Registry (individuals) 202602 publisher: Centers for Medicare & Medicaid Services retrieved: 2026-06-10 sha256: 8b5267e250fd4df6… claim API: JSON |
| primary_taxonomy | 314000000X | 2026-06-10 | Centers for Medicare & Medicaid ServicesNPPES NPI Registry (individuals) 202602 publisher: Centers for Medicare & Medicaid Services retrieved: 2026-06-10 sha256: 8b5267e250fd4df6… claim API: JSON |
Provider screening signals
NPI-keyed source families read directly for 1881681559: federal and state integrity lists, CMS Open Payments, Order and Referring eligibility, Medicare opt-out, and enrollment revalidation. Cells expose the source and provenance fields supplied by the selected record. A screening aid — re-confirm any match against the primary source before acting; absence means nothing on file in the data Fonteum currently holds, never a guarantee none exists.
Sanctions & integrity
Coverage staleExclusion coverage is stale or cannot be reconciled to an attested source artifact. This result is indeterminate and must not be treated as a clearance; check the current issuing-agency lists.
- Coverage status: indeterminate
- Screened 26 integrity lists; no negative determination was made.
14-tuple provenance (26)
Industry payments
None on file0 CMS Open Payments records on file for this NPI.
14-tuple provenance (1)
Order & referring eligibility
None on fileNo CMS Order and Referring record on file for this NPI.
14-tuple provenance (1)
Medicare opt-out
None on fileNo CMS Medicare opt-out affidavit on file for this NPI.
14-tuple provenance (1)
Revalidation
On file1 Medicare enrollment record on file.
- Due date: TBD upstream — not due within the ensuing six months.
14-tuple provenance (1)
Point-in-time
Query retained claim coordinates under bitemporal-read/v1. Most facts have no superseded row; dates outside retained coverage may return no prior version, and diffs require both coordinates.
Pick a date to reconstruct, or two dates to diff. Equivalent JSON: /api/v1/history/{subject_type}/{subject_id}?at=… and …/diff?from=…&to=…