Emanate Health Medical Center
Organization Active NPI Psychiatric Hospital Unit · Covina, CA
NPI 1215063151 · NPPES record last updated Oct 27, 2020
Key facts
- NPI
- 1215063151
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Psychiatric Hospital Unit 273R00000X
- Legal business name
- EMANATE HEALTH MEDICAL CENTER
- Practice address
- 210 W San Bernardino Rd
Covina, CA 91723-1515 - Phone
- (626) 331-7331
- NPI assigned
- Feb 26, 2007
- Organization subpart
- Yes
- Parent organization (as reported)
- EMANATE HEALTH
Authorized official
- Name
- Roger Sharma
- Title
- Executive VP/Cfo
- Phone
- (626) 938-7595
Owners & managing parties with NPI records 6
-
Thomas Orville Bryan, M.D.
-
Sanjay Natverlal Khedia, M.D.
-
Philip Byron Maldonado, D.D.S.
-
Sharon Juliana Yee, M.D.
Other NPIs on the same Medicare enrollment 2
Corporate family (same tax ID) 3
Related certifications (CCN) 1
Affiliated clinicians 469
-
Ali Abidali, DO
-
Latha Madhavi Achanta, MD MPH
-
Iman Afrooz, M.D
-
Sam Ahdab, M.D.
-
Aziz Ahmad, M.D.
-
Kabir Ahmed, M.D.
-
Khwaja Arsalaan Ahmed, M.D.
-
Jaspreet S Ahuja, MD
-
Mumtaz Akram, M.D.
-
Bachar Ali, D.O.
-
Steven D Alvarez-Mott, M.D.
-
Krystal Alvarez, NP
-
Ramin Amirnovin, MD
-
Apoorva Ananth, MD
-
Alexander Anavim, MD
-
Olga Anikina, MD
-
Ala Arafa-Price, M.D
-
Jesus Arenas, M.D.
-
Sartaj M Arora, MD
Medicare Care Compare: Hospital
- Listed as
- Emanate Health Inter-Community Hospital
- Overall star rating
- ★☆☆☆☆ 1 of 5
- Type
- Acute Care Hospitals
- Ownership
- Proprietary
- Medicare certification status
- Active
- Emergency services
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
Hospital certification: CCN 050382
- Legal name
- EMANATE HEALTH MEDICAL CENTER
- Doing business as
- EMANATE HEALTH INTER-COMMUNITY HOSPITAL
- Certification status
- Active
- Provider type (POS)
- Hospital – Short-term
- Participating since
- Jul 1, 1966
- Last certification
- Apr 14, 2023
- Beds
- 193
- Ownership / control type
- Private (for profit)
- Organization structure
- Corporation · Non-profit
- Incorporated
- Aug 4, 1959 in CA
- Enrollment address
- 210 W San Bernardino Rd
Covina, CA 91723-1515 - Hospital subgroups
- General, Acute care
All disclosed owners & managing parties 16
| Name | Role | Since | Share |
|---|---|---|---|
| Walter Allen |
Corporate Director |
Jun 1, 2024 | |
| Gary Mathewson |
Corporate Director | Oct 30, 2007 | |
| Sanjay Natverlal Khedia |
Corporate Director | Sep 1, 2023 | |
| Raffaele M Corbisiero |
Corporate Director |
Jan 1, 2024 | |
| Thomas O. Bryan |
Corporate Director | Jun 1, 2024 | |
| Clifford Charles Christ |
Corporate Director | Oct 30, 2007 | |
| Rajesh K Sharma |
Corporate Officer |
Jul 31, 2013 | |
| Philip B Maldonado |
Corporate Officer | Jun 1, 2023 | |
| Patsy Gorrell |
Corporate Director | Oct 30, 2007 | |
| Mary Kirchen |
Corporate Director | Oct 30, 2007 | |
| Emanate Health |
5% Or Greater Direct Ownership Interest | Oct 15, 2018 | 100% |
| Operational/Managerial Control | Oct 15, 2018 | 100% | |
| Sharon Juliana Yee |
Corporate Director |
Jun 1, 2016 | |
| Lucrecia Montes |
Corporate Director | Jun 1, 2016 | |
| Brenda N Hayakawa |
Corporate Director |
Jan 1, 2024 | |
| Robert Gonzales |
Corporate Officer | Jan 1, 2023 | |
| Eddie Arvayo |
Operational/Managerial Control |
Feb 1, 2023 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20071102000637 | CA | Part a Provider - Hospital | 0143317453 |
2 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Covina, CA; West Covina, CA |
National Provider Directory
- Tax ID family
- Emanate Health Medical Center
- Part of
- Citrus Valley Health Partners
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric Hospital Unit | 273R00000X | Yes |
Addresses
Primary practice location
210 W San Bernardino Rd
Covina, CA 91723-1515
Mailing address
PO Box 840145
Los Angeles, CA 90084-0145
Phone (626) 331-7331
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| ZZZC1911Z | Other | CA | BLUE SHIELD |
| 002 | Other | CA | BLUE CROSS |
| HSM30382G | Medicaid | CA |
Other names
- Emanate Health Inter-Community Hospital
- Intercommunity Medical Center Mental Health
- Citrus Valley Medical Center,Inc
Other providers in Covina, CA
- Elsa Elizalde
- Hassan Ali Elreda
- Elsherif DDS a Professional Corporation
- Ismail Ibrahim Elsherif
- Emanate Health Ipa
- Emanate Health Medical Center
- Emanate Health Medical Center
- Emanate Health Medical Center
- Emanate Health Medical Center
- Emanate Health Medical Center
All providers in Covina, CA · Psychiatric Hospital Unit in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 27, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.