Organization
EMANATE HEALTH MEDICAL CENTER
Active
Parent organization
EMANATE HEALTH
Other names
Intercommunity Medical Center Mental Health, Emanate Health Inter-Community Hospital, Citrus Valley Medical Center,Inc
Organization subpart
Yes
Provider details
NPI number
Legal business name
EMANATE HEALTH
Authorized official
ROGER SHARMA (EXECUTIVE VP/CFO)
(626) 938-7595
Entity
Organization
Contact information
Practice address
210 W SAN BERNARDINO RD, COVINA, CA 91723-1515
(626) 331-7331
Mailing address
PO BOX 840145, LOS ANGELES, CA 90084-0145
(626) 331-7331
Taxonomy
Speciality
Code
Description
License number
State
273R00000X
Psychiatric Hospital Unit
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
002
BLUE CROSS
CA
05
—
HSM30382G
—
CA
01
—
ZZZC1911Z
BLUE SHIELD
CA
Enumeration date
02/26/2007
Last updated
10/27/2020
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