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 | 1497742167 | nppes_providers | deterministic_pk | 1.000 | 2026-06-10 | evidencerecorded: 2026-06-10 methodology: entity-graph/v1 evidence: {"rule":"D-NPI","source_pk":"1497742167","entity_type_code":"2"} |
| pac_id | 6406022789 | pecos_providers | exact_npi_in_pecos | 1.000 | 2026-06-16 | evidencerecorded: 2026-06-16 methodology: entity-graph/v1 evidence: {"npi":"1497742167","rule":"D-PECOS","enrlmt_id":"O20120109000535","pecos_asct_cntl_id":"6406022789"} |
| pecos_enrlmt_id | O20120109000535 | pecos_providers | exact_npi_in_pecos | 1.000 | 2026-06-16 | evidencerecorded: 2026-06-16 methodology: entity-graph/v1 evidence: {"npi":"1497742167","rule":"D-PECOS","enrlmt_id":"O20120109000535"} |
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":"43","association_date":"03/16/2000","percentage_ownership":null} evidence: {"rule":"D-OWNER","owner_pac":"0648412486","source_pk":111256,"type_owner":"I","enrollment_id":"O20120109000535","role_code_owner":"43","role_text_owner":"OPERATIONAL/MANAGERIAL CONTROL","dst_resolved_via":"pecos_enrlmt_id","percentage_ownership_raw":null,"enrollment_organization_name":"8520 WESTERN AVENUE 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":null} evidence: {"rule":"D-OWNER","owner_pac":"0941341648","source_pk":111258,"type_owner":"I","enrollment_id":"O20120109000535","role_code_owner":"40","role_text_owner":"CORPORATE OFFICER","dst_resolved_via":"pecos_enrlmt_id","percentage_ownership_raw":null,"enrollment_organization_name":"8520 WESTERN AVENUE INC"} |
| ← owns | FARIBORZ SHAMS (CA) | 1.000 | snf_all_owners | evidencerecorded: 2026-06-16 methodology: entity-graph/v1 attributes: {"role_code":"43","association_date":"01/01/2021","percentage_ownership":null} evidence: {"rule":"D-OWNER","owner_pac":"1557449527","source_pk":111261,"type_owner":"I","enrollment_id":"O20120109000535","role_code_owner":"43","role_text_owner":"OPERATIONAL/MANAGERIAL CONTROL","dst_resolved_via":"pecos_enrlmt_id","percentage_ownership_raw":null,"enrollment_organization_name":"8520 WESTERN AVENUE 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":111263,"type_owner":"O","enrollment_id":"O20120109000535","role_code_owner":"72","role_text_owner":"ADP OF THE SNF","dst_resolved_via":"pecos_enrlmt_id","percentage_ownership_raw":null,"enrollment_organization_name":"8520 WESTERN AVENUE INC"} |
| ← owns | SIMCHA MANDELBAUM | 1.000 | snf_all_owners | evidencerecorded: 2026-06-16 methodology: entity-graph/v1 attributes: {"role_code":"43","association_date":"03/01/2026","percentage_ownership":null} evidence: {"rule":"D-OWNER","owner_pac":"2466346614","source_pk":111264,"type_owner":"I","enrollment_id":"O20120109000535","role_code_owner":"43","role_text_owner":"OPERATIONAL/MANAGERIAL CONTROL","dst_resolved_via":"pecos_enrlmt_id","percentage_ownership_raw":null,"enrollment_organization_name":"8520 WESTERN AVENUE INC"} |
| ← owns | JOCELYN JACINTO | 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":"3678080256","source_pk":111266,"type_owner":"I","enrollment_id":"O20120109000535","role_code_owner":"43","role_text_owner":"OPERATIONAL/MANAGERIAL CONTROL","dst_resolved_via":"pecos_enrlmt_id","percentage_ownership_raw":null,"enrollment_organization_name":"8520 WESTERN AVENUE INC"} |
| ← owns | GVBP REAL ESTATE HOLDINGS, LLC (CA) | 1.000 | snf_all_owners | evidencerecorded: 2026-06-16 methodology: entity-graph/v1 attributes: {"role_code":"72","association_date":"12/05/2023","percentage_ownership":null} evidence: {"rule":"D-OWNER","owner_pac":"3779090352","source_pk":111268,"type_owner":"O","enrollment_id":"O20120109000535","role_code_owner":"72","role_text_owner":"ADP OF THE SNF","dst_resolved_via":"pecos_enrlmt_id","percentage_ownership_raw":null,"enrollment_organization_name":"8520 WESTERN AVENUE INC"} |
| ← owns | FRENCITA NAVARRO | 1.000 | snf_all_owners | evidencerecorded: 2026-06-16 methodology: entity-graph/v1 attributes: {"role_code":"43","association_date":"05/01/2022","percentage_ownership":null} evidence: {"rule":"D-OWNER","owner_pac":"4587171160","source_pk":111269,"type_owner":"I","enrollment_id":"O20120109000535","role_code_owner":"43","role_text_owner":"OPERATIONAL/MANAGERIAL CONTROL","dst_resolved_via":"pecos_enrlmt_id","percentage_ownership_raw":null,"enrollment_organization_name":"8520 WESTERN AVENUE INC"} |
| ← owns | SKILLSERVE INC (CA) | 1.000 | snf_all_owners | evidencerecorded: 2026-06-16 methodology: entity-graph/v1 attributes: {"role_code":"72","association_date":"12/20/2007","percentage_ownership":null} evidence: {"rule":"D-OWNER","owner_pac":"4587939145","source_pk":111271,"type_owner":"O","enrollment_id":"O20120109000535","role_code_owner":"72","role_text_owner":"ADP OF THE SNF","dst_resolved_via":"pecos_enrlmt_id","percentage_ownership_raw":null,"enrollment_organization_name":"8520 WESTERN AVENUE INC"} |
| ← owns | MARIA CASTRO-GARCIA | 1.000 | snf_all_owners | evidencerecorded: 2026-06-16 methodology: entity-graph/v1 attributes: {"role_code":"40","association_date":"01/04/2021","percentage_ownership":null} evidence: {"rule":"D-OWNER","owner_pac":"4688061286","source_pk":111272,"type_owner":"I","enrollment_id":"O20120109000535","role_code_owner":"40","role_text_owner":"CORPORATE OFFICER","dst_resolved_via":"pecos_enrlmt_id","percentage_ownership_raw":null,"enrollment_organization_name":"8520 WESTERN AVENUE 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":111275,"type_owner":"O","enrollment_id":"O20120109000535","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":"8520 WESTERN AVENUE INC"} |
| ← owns | VANN RAMA | 1.000 | snf_all_owners | evidencerecorded: 2026-06-16 methodology: entity-graph/v1 attributes: {"role_code":"43","association_date":"11/01/2024","percentage_ownership":null} evidence: {"rule":"D-OWNER","owner_pac":"5496188302","source_pk":111276,"type_owner":"I","enrollment_id":"O20120109000535","role_code_owner":"43","role_text_owner":"OPERATIONAL/MANAGERIAL CONTROL","dst_resolved_via":"pecos_enrlmt_id","percentage_ownership_raw":null,"enrollment_organization_name":"8520 WESTERN AVENUE INC"} |
| ← owns | MARICOR MOYO | 1.000 | snf_all_owners | evidencerecorded: 2026-06-16 methodology: entity-graph/v1 attributes: {"role_code":"43","association_date":"03/09/2022","percentage_ownership":null} evidence: {"rule":"D-OWNER","owner_pac":"5496262073","source_pk":111278,"type_owner":"I","enrollment_id":"O20120109000535","role_code_owner":"43","role_text_owner":"OPERATIONAL/MANAGERIAL CONTROL","dst_resolved_via":"pecos_enrlmt_id","percentage_ownership_raw":null,"enrollment_organization_name":"8520 WESTERN AVENUE 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":30} evidence: {"rule":"D-OWNER","owner_pac":"7012373509","source_pk":111280,"type_owner":"O","enrollment_id":"O20120109000535","role_code_owner":"34","role_text_owner":"5% OR GREATER DIRECT OWNERSHIP INTEREST","dst_resolved_via":"pecos_enrlmt_id","percentage_ownership_raw":30,"enrollment_organization_name":"8520 WESTERN AVENUE 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":20} evidence: {"rule":"D-OWNER","owner_pac":"8224423348","source_pk":111281,"type_owner":"O","enrollment_id":"O20120109000535","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":"8520 WESTERN AVENUE INC"} |
Current record
Current claims returned for this entity, grouped by provenance subject. The table exposes the source identifier recorded for each claim.
org · 1497742167 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 | 8520 WESTERN AVENUE 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 1497742167: 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=…