# WEST COVINA MEDICAL CENTER, INC.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1255723490
- **Authorized official:** MS. VICKI P ROLLINS RN (VICE-PRESIDENT)
- **Authorized official phone:** (626) 338-8481

## Contact information

- **Practice address:** 725 S ORANGE AVE, WEST COVINA, CA 91790-2614
- **Practice address phone:** (626) 338-8481
- **Practice address fax:** (626) 960-9178
- **Mailing address:** 725 S ORANGE AVE, WEST COVINA, CA 91790-2614
- **Mailing address phone:** (626) 338-8481
- **Mailing address fax:** (626) 960-9178

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | 930000188 | CA | Yes |

## Other

- **Enumeration date:** 02/25/2015
- **Last updated:** 07/21/2016

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 930000188 | — | CA |