# EMANATE HEALTH MEDICAL CENTER

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** EMANATE HEALTH
- **Other names:** CITRUS VALLEY MEDICAL CENTER INC, Emanate Health Queen of the Valley Hospital
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1740214808
- **Legal business name:** EMANATE HEALTH
- **Authorized official:** ROGER SHARMA (EXECUTIVE VP/CFO)
- **Authorized official phone:** (626) 938-7595

## Contact information

- **Practice address:** 1115 S SUNSET AVE, WEST COVINA, CA 91790-3940
- **Practice address phone:** (626) 962-4011
- **Mailing address:** DEPT\# 0147, LOS ANGELES, CA 90084-0147
- **Mailing address phone:** (626) 814-0333

## Taxonomy

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

## Other

- **Enumeration date:** 07/11/2006
- **Last updated:** 10/27/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 209 | BLUE CROSS SO CA | CA |
| 05 | — | LTC55556F | — | CA |
| 01 | — | ZZZA1939Z | BLUE SHIELD CA | CA |