Emanate Health Medical Group

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

Legal business name

EMANATE HEALTH MEDICAL GROUP

Practice address

210 W San Bernardino Rd
Covina, CA 91723-1515

Phone

(626) 858-8580

Fax

(626) 858-8582

NPI assigned

Mar 2, 2016

Last updated

Jul 11, 2019By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Jacqueline Bracy, MD

Title

President

Phone

(626) 858-8580

Specialties & licenses 2

Addresses

Other names 1

• Citrus Valley Physician Partners Former legal business name

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Emanate Health Medical Group

  dba Foothill Family Practice

  • Family Medicine Physician
  • Glendora, CA
  • NPI 1326582743

  O20170130001647

  Same enrollment

Practitioners 105

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Steven D Alvarez-Mott, M.D.

  • Obstetrics & Gynecology Physician
  • Glendora, CA
  • NPI 1659373850
  NPD
• Parvane Barati, DO

  • Family Medicine Physician
  • West Covina, CA
  • NPI 1851958052
  NPD
• Emily Ruth Berry, M.D.

  • Surgery Physician
  • Glendora, CA
  • NPI 1700295425
  NPD
• Najib Bouz, M.D.

  • Obstetrics & Gynecology Physician
  • Glendora, CA
  • NPI 1265434591
  NPD
• Alex Casey, DO

  • Family Medicine Physician
  • San Dimas, CA
  • NPI 1710544077
  NPD
• Vivere Jabonillo Castro

  • Family Nurse Practitioner
  • West Covina, CA
  • NPI 1154087641
  NPD
• Cynthia Chen-Joea, D.O,

  • Family Medicine Physician
  • West Covina, CA
  • NPI 1033573043
  NPD
• Brittany Everson, DPM

  • Foot & Ankle Surgery Podiatrist
  • Glendora, CA
  • NPI 1891349932
  NPD
• Humberto A Galleno, M.D.

  • Orthopaedic Surgery Physician
  • Covina, CA
  • NPI 1760410757
  NPD
• Luis Genaro Garcia Ayala

  • Family Medicine Physician
  • West Covina, CA
  • NPI 1750867255
  NPD
• Ruby Gonzalez, M.D.

  • Family Medicine Physician
  • Glendora, CA
  • NPI 1306226915

  Single Specialty

  NPD
• Jessica Lee Guevara-Galan, BSN,MSN, WHNP

  • Women's Health Nurse Practitioner
  • West Covina, CA
  • NPI 1558728717
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1456876800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1562803200000",
    "number": "1881054997",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 W SAN BERNARDINO RD",
            "city": "COVINA",
            "state": "CA",
            "postal_code": "917231515",
            "telephone_number": "626-858-8580",
            "fax_number": "626-858-8582"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 W SAN BERNARDINO RD",
            "city": "COVINA",
            "state": "CA",
            "postal_code": "917231515",
            "telephone_number": "626-858-8580",
            "fax_number": "626-858-8582"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EMANATE HEALTH MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-03-02",
        "last_updated": "2019-07-11",
        "status": "A",
        "authorized_official_last_name": "BRACY",
        "authorized_official_first_name": "JACQUELINE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "626-858-8580",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "CA",
            "license": null,
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Citrus Valley Physician Partners",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Emanate Health Medical Center (Emanate Health Inter-Community Hospital)
• Emanate Health Medical Center (Citrus Valley Medical Center InterCommunity Skilled Nursing Facility)
• Emanate Health Medical Center (Emanate Health Inter-Community Hospital)
• Emanate Health Medical Center (Emanate Health Inter-Community Hospital)
• Emanate Health Medical Center (Citrus Valley Medical Center Inter-Community Campus)
• Empower Psych Services
• Angelica Marie Encalada
• Andrew Gabriel Encinas
• Encore Surgery Center Inc.
• Jonathan Endriga

• General Practice Physician in Covina, CA
• Providers in Covina, CA by specialty
• General Practice Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.