EMANATE HEALTH MEDICAL CENTER (NPI# 1629009097) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1629009097 |
| Entity Type | Organization |
| Organization Name | EMANATE HEALTH MEDICAL CENTER |
| Other Organization Name | CITRUS VALLEY MEDICAL CENTER INC. |
| Practice Address |
210 W San Bernardino Rd Covina CA 91723-1515 |
| Mailing Address |
Po Box 840149 Los Angeles CA 90084-0149 |
| Practice Telephone | 6263317331 |
| Mailing Telephone | 6263317331 |
| Enumeration Date | 2006-07-05 |
| Last Update Date | 2020-10-27 |
| Authorized Official Name | ROGER SHARMA (EXECUTIVE VP/CFO) |
| Authorized Official Telephone | 6269387595 |
| Is Organization Subpart | Y |
| Parent Organization Name | EMANATE HEALTH |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 314000000X | Skilled Nursing Facility | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | BLUE SHIELD CA | ZZC1911Z | 01 |
| CA | LTC55610F | 05 | |
| CA | BLUE CROSS SO CAL | 002 | 01 |
| Other Name | Type Code |
|---|---|
| Citrus Valley Medical Center Inc. | Former Legal Business Name - Organization |
| Citrus Valley Medical Center InterCommunity Skilled Nursing Facility | Doing Business As Name - Organization |
| Emanate Health Inter-Community Hospital | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407871965 | Emanate Health Medical Center | Specialist | 315 N 3rd Ave Ste 203, Covina, CA 91723-1915 | 2006-07-13 |
| 1215063151 | Emanate Health Medical Center | Psychiatric Unit | 210 W San Bernardino Rd, Covina, CA 91723-1515 | 2007-02-26 |
| 1669507620 | Emanate Health Medical Center | General Acute Care Hospital | 210 W San Bernardino Rd, Covina, CA 91723-1515 | 2007-02-22 |
| 1982629440 | Emanate Health Medical Center | General Acute Care Hospital | 210 W San Bernardino Rd, Covina, CA 91723-1515 | 2006-07-13 |
| 1881619344 | Emanate Health Medical Center | Specialist | 210 W San Bernardino Rd, Covina, CA 91723-1515 | 2006-07-13 |
| 1770508939 | Emanate Health Medical Center | Specialist | 1115 S Sunset Ave, West Covina, CA 91790-3940 | 2006-07-12 |
| 1548294606 | Emanate Health Medical Center | Rehabilitation Unit | 1115 S Sunset Ave, West Covina, CA 91790-3940 | 2006-07-11 |
| 1740214808 | Emanate Health Medical Center | Skilled Nursing Facility | 1115 S Sunset Ave, West Covina, CA 91790-3940 | 2006-07-11 |
| 1063441293 | Emanate Health Medical Center | General Acute Care Hospital | 1115 S Sunset Ave, West Covina, CA 91790-3940 | 2006-07-01 |
| Street Address |
210 W SAN BERNARDINO RD |
| City | COVINA |
| State | CA |
| Zip Code | 91723-1515 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114921616 | Uri Martin Zisblatt | Radiology | 210 W San Bernardino Rd, Dept of Rad Onc, Covina, CA 91723-1515 | 2005-06-13 |
| 1164021457 | Kendira Villalobos | Occupational Therapist | 210 W San Bernardino Rd, Covina, CA 91723-1515 | 2020-10-19 |
| 1487260113 | Janet C Cruz | Nurse Practitioner | 210 W San Bernardino Rd, Covina, CA 91723-1515 | 2020-09-17 |
| 1730711037 | Shaheen Kaukab Akram | Registered Nurse | 210 W San Bernardino Rd, Covina, CA 91723-1515 | 2020-02-05 |
| 1538790340 | Annette Doria Lau | Registered Nurse | 210 W San Bernardino Rd, Covina, CA 91723-1515 | 2020-01-30 |
| 1760013858 | Frederick John Ruiz Go | Registered Nurse | 210 W San Bernardino Rd, Covina, CA 91723-1515 | 2020-01-28 |
| 1134750474 | Benjamin Herrick | Nurse Practitioner | 210 W San Bernardino Rd, Covina, CA 91723-1515 | 2020-01-27 |
| 1639729833 | Ryan Edward Estrada | Physician Assistant | 210 W San Bernardino Rd, Covina, CA 91723-1515 | 2019-09-19 |
| 1235787680 | Tatianna Elisa De Franco | Registered Nurse | 210 W San Bernardino Rd, Covina, CA 91723-1515 | 2019-08-29 |
| 1225685258 | Cristina Rusu | Registered Nurse | 210 W San Bernardino Rd, Covina, CA 91723-1515 | 2019-08-23 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316550593 | Joshua Mercado | Behavior Technician | 210 N. Citrus Ave., Covina, CA 91723 | 2020-08-26 |
| 1578104790 | Alda Shin Shin | Behavioral Analyst | 1343 S. Grand Avenue, Suite 200, Covina, CA 91723 | 2019-09-30 |
| 1063074490 | Julia De La Torre | Student in an Organized Health Care Education/Training Program | 540 S Eremland Drive, Covina, CA 91723 | 2019-07-05 |
| 1336639368 | Counseling Solutions for Children and Families, Psychology Corporation | Community/Behavioral Health | 271 E Workman St Ste 101, Covina, CA 91723 | 2018-05-15 |
| 1669995916 | Helen Wang Le | Optometrist | 554 E San Bernardino Rd Ste 102, Covina, CA 91723 | 2017-07-19 |
| 1992242879 | Donovan Kouthiraj | Behavior Technician | 210 N Citrus Ave Ste A1, Covina, CA 91723 | 2017-01-30 |
| 1427406339 | Robinson Baron Medical Clinic | Surgery | 274 W Badillo Street, Covina, CA 91723 | 2016-06-01 |
| 1306211123 | Absolute Senior Care Services, Inc | In Home Supportive Care | 599 S Barranca Ave Ste 205, Covina, CA 91723 | 2015-12-04 |
| 1780061135 | Mohan Ckd Clinic | Internal Medicine | 171 W Cottage St, Covina, CA 91723 | 2015-05-05 |
| 1992198915 | Toshihisa Takei | Otolaryngology | 202 West College Street, Covina, CA 91723 | 2015-03-16 |
| Find all providers in zip 91723 | ||||
| Taxonomy Code | 314000000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Skilled Nursing Facility |
| (1) A skilled nursing facility is a facility or distinct part of an institution whose primary function is to provide medical, continuous nursing, and other health and social services to patients who are not in an acute phase of illness requiring services in a hospital, but who require primary restorative or skilled nursing services on an inpatient basis above the level of intermediate or custodial care in order to reach a degree of body functioning to permit self care in essential daily living. It meets any licensing or certification standards et forth by the jurisdiction where it is located. A skilled nursing facility may be a freestanding facility or part of a hospital that has been certified by Medicare to admit patients requiring subacute care and rehabilitation; (2) Provides non-acute medical and skilled nursing care services, therapy and social services under the supervision of a licensed registered nurse on a 24-hour basis. |
| Notes: Source: (1) "Glossary of terms used in managed care" Developed by the Managed Care Assembly (MCA) of Medical Group Management Association (MGMA), MGM Journal, September/October 1995, p. 64; (2) AHA Guide, 1996 Annual Survey. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639726102 | Masonic Homes of California | Skilled Nursing Facility | 161 S Reeder Ave, Covina, CA 91724-3129 | 2019-08-20 |
| 1992885958 | Covina Care Center, Inc. | Skilled Nursing Facility | 261 W Badillo St, Covina, CA 91723-1907 | 2006-10-16 |
| 1376593004 | Rowland Convalescent Hospital Inc | Skilled Nursing Facility | 330 W Rowland St, Covina, CA 91723-2941 | 2006-05-11 |
| 1700874393 | Camtrent LLC | Skilled Nursing Facility | 519 W Badillo St, Covina, CA 91722-3763 | 2005-10-08 |
| 1306476742 | Harvard Creek Post Acute, LLC | Skilled Nursing Facility | 519 W Badillo St, Covina, CA 91722-3763 | 2020-01-24 |
| 1861415879 | Camtrent, LLC | Skilled Nursing Facility | 519 W Badillo St, Covina, CA 91722-3763 | 2006-07-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073114807 | The Healing Sanctum-greenmeadow, LLC | Skilled Nursing Facility | 5302 E Greenmeadow Rd, Long Beach, CA 90808-1620 | 2020-11-06 |
| 1528667581 | Winterfest Medical Services Corporation | Skilled Nursing Facility | 8758 Winterfest Way, Elk Grove, CA 95624-1295 | 2020-10-21 |
| 1689272528 | Orchards Hc LLC | Skilled Nursing Facility | 1 Amistad Drive, Rancho Mission Viejo, CA 92694 | 2020-10-13 |
| 1083223481 | Santa Clarita Congregate Living Inc | Skilled Nursing Facility | 29830 Wisteria Valley Rd, Santa Clarita, CA 91387-1954 | 2020-07-31 |
| 1033737051 | Beautiful Homes Residential Care Inc | Skilled Nursing Facility | 22525 Cerise Ave, Torrance, CA 90505-2913 | 2020-07-07 |
| 1043837966 | Desert Ridge Transitional Care Center, Lp | Skilled Nursing Facility | 13300 11th Avenue, Victorville, CA 92395 | 2020-06-26 |
| 1881210847 | Ghc of Tem - Snf, LLC | Skilled Nursing Facility | 44320 Campanula Way, Temecula, CA 92592-7903 | 2020-06-24 |
| 1861018327 | Covina Clhf Corporation | Skilled Nursing Facility | 1411 S Sandia Ave, West Covina, CA 91790-3309 | 2020-06-22 |
| 1780204024 | Neighbor Care Congregate Home, Inc. | Skilled Nursing Facility | 3249 Gerald Dr, Newbury Park, CA 91320-2948 | 2020-04-16 |
| 1558998047 | Sunflower Clhf, Inc. | Skilled Nursing Facility | 1058 Ruberta Ave, Glendale, CA 91201-2105 | 2020-03-24 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.