Organization
EMANATE HEALTH MEDICAL CENTER
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
Legal business name
EMANATE HEALTH
Authorized official
ROGER SHARMA (EXECUTIVE VP/CFO)
(626) 938-7595
Entity
Organization
Contact information
Practice address
1115 S SUNSET AVE, WEST COVINA, CA 91790-3940
(626) 962-4011
Mailing address
DEPT# 0147, LOS ANGELES, CA 90084-0147
(626) 814-0333
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
209
BLUE CROSS SO CA
CA
05
—
LTC55556F
—
CA
01
—
ZZZA1939Z
BLUE SHIELD CA
CA
Enumeration date
07/11/2006
Last updated
10/27/2020
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