NPIMap

Organization Active NPI

Emanate Health Medical Center

Doing business as Citrus Valley Medical Center Inter-Community Campus

  • General Acute Care Hospital
  • Covina, CA
National Provider Identifier
1982629440
Registry record updated Mar 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Acute Care HospitalTaxonomy code 282N00000X
Legal business name
EMANATE HEALTH MEDICAL CENTER
Doing business as
Citrus Valley Medical Center Inter-Community Campus
Emanate Health Inter-Community Hospital
Practice address
210 W San Bernardino Rd
Covina, CA 91723-1515
Phone
(626) 331-7331
NPI assigned
Jul 13, 2006
Last updated
Mar 22, 2021By the provider in NPPES
Organization subpart
Yes
Parent organization
EMANATE HEALTHAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 22, 2021

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

Authorized official

Name
Roger Sharma
Title
Executive VP/Cfo
Phone
(626) 938-7595

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Acute Care Hospital 282N00000X Primary

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) 732-3100

Other identifiers 6

IdentifierTypeStateIssuer
002OtherCABLUE CROSS SO CALIFORNIA
HSM30382GMedicaidCA
ZZT40382GMedicaidCA
HSC30382GMedicaidCA
ZZT30382FMedicaidCA
ZZZC1911ZOtherCABLUE SHIELD OF CALIFORNIA

Other names 3

  • Citrus Valley Medical Center Inter-Community Campus Doing business as
  • Emanate Health Inter-Community Hospital Doing business as
  • CITRUS VALLEY MEDICAL CENTER INC Former legal business name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20071102000637 CA Part A Provider - Hospital 0143317453 2 other NPIs on this enrollment
Practice locations: Covina, CA; West Covina, CA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1982629440. Details of each certification follow.

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
CorporationNon-profit
Incorporated
Aug 4, 1959 in CA
Enrollment address
210 W San Bernardino Rd
Covina, CA 91723-1515
Hospital subgroups
General, Acute care

Facilities connected through Provider of Services related, parent or unit certification numbers.

Other NPIs with the same Medicare PAC ID 3

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 2

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

Care Compare: Hospital

Medicare Care Compare
Listed as
Emanate Health Inter-Community HospitalCCN 050382 · All quality measures
Overall star rating
1 of 5
Type
Acute Care Hospitals
Ownership
Proprietary
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

National Provider Directory

National Provider Directory
Tax ID family
Citrus Valley Medical Center Inc2 organizations share this tax ID, including this one
Part of
Citrus Valley Health Partners

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

453 E Arrow Hwy
Ste B
Azusa, CA 91702
Phone (626) 915-1748

14708 Pipeline Ave
Ste D
Chino Hills, CA 91709
Phone (909) 265-4858

18605 Gale Ave
Ste 240
City of Industry, CA 91748
Phone (626) 581-1282

174 W Badillo St
Covina, CA 91723
Phone (626) 331-7369

315 N 3rd Ave
Ste 300
Covina, CA 91723
Phone (626) 337-3500

368 W Badillo St
Covina, CA 91723
Phone (626) 915-5161

475 W Badillo St
Covina, CA 91723
Phone (626) 331-2209

888 Brea Canyon Rd
Ste 270
Diamond Bar, CA 91789
Phone (626) 912-9345

10418 Valley Blvd
Ste B
El Monte, CA 91731
Phone (626) 453-8466

1100 E Broadway
Ste 205
Glendale, CA 91205
Phone (818) 453-5192

415 W Route 66
Ste 101
Glendora, CA 91740
Phone (626) 327-2763

1840 N Hacienda Blvd
Ste 6
La Puente, CA 91744
Phone (626) 917-4871

1012 W Beverly Blvd
Montebello, CA 90640

1050 Lakes Dr
Ste 100
West Covina, CA 91790
Phone (626) 918-6655

1250 S Sunset Ave
Ste 201
West Covina, CA 91790
Phone (626) 814-1924

1500 W West Covina Pkwy
Ste 201
West Covina, CA 91790
Phone (626) 263-7020

421 E Merced Ave
West Covina, CA 91790
Phone (626) 918-1881

Ownership & related parties

All disclosed owners & managing parties 16

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Walter Allen Individual Corporate DirectorBoard Member Jun 1, 2024
Gary Mathewson Individual Corporate Director Oct 30, 2007
Sanjay Natverlal Khedia Individual Corporate Director Sep 1, 2023
Raffaele M Corbisiero Individual Corporate DirectorBoard Member Jan 1, 2024
Thomas O. Bryan Individual Corporate Director Jun 1, 2024
Clifford Charles Christ Individual Corporate Director Oct 30, 2007
Rajesh K Sharma Individual Corporate OfficerPresident/Ceo Jul 31, 2013
Philip B Maldonado Individual Corporate Officer Jun 1, 2023
Patsy Gorrell Individual Corporate Director Oct 30, 2007
Mary Kirchen Individual Corporate Director Oct 30, 2007
Emanate Health Organization, Covina, CA Created for acquisition, Corporation, Non-profit 5% Or Greater Direct Ownership Interest Oct 15, 2018 100%
Operational/Managerial Control Oct 15, 2018 100%
Sharon Juliana Yee Individual Corporate DirectorBoard Member Jun 1, 2016
Lucrecia Montes Individual Corporate Director Jun 1, 2016
Brenda N Hayakawa Individual Corporate DirectorBoard Member Jan 1, 2024
Robert Gonzales Individual Corporate Officer Jan 1, 2023
Eddie Arvayo Individual Operational/Managerial ControlFinance Director Feb 1, 2023

Owners & managing parties with NPI records 6

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Facilities with the same owner 3

Facilities that share an organizational owner with 5% or greater ownership or operational control.

Practitioners & affiliated clinicians

Practitioners 238

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.

View all 238

Affiliated clinicians 469

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 469

NPI Registry JSON

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

{
    "created_epoch": "1152748800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1616371200000",
    "number": "1982629440",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 840145",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900840145",
            "telephone_number": "626-732-3100"
        },
        {
            "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": "626-331-7331"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EMANATE HEALTH MEDICAL CENTER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "EMANATE HEALTH",
        "enumeration_date": "2006-07-13",
        "last_updated": "2021-03-22",
        "certification_date": "2021-03-22",
        "status": "A",
        "authorized_official_last_name": "SHARMA",
        "authorized_official_first_name": "ROGER",
        "authorized_official_title_or_position": "EXECUTIVE VP/CFO",
        "authorized_official_telephone_number": "626-938-7595"
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS SO CALIFORNIA",
            "identifier": "002",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "HSM30382G",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ZZT40382G",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "HSC30382G",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ZZT30382F",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD OF CALIFORNIA",
            "identifier": "ZZZC1911Z",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Citrus Valley Medical Center Inter-Community Campus",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Citrus Valley Medical Center Inter-Community Campus",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Emanate Health Inter-Community Hospital",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "CITRUS VALLEY MEDICAL CENTER INC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Covina, CA

Sources for this page

Verify at the official NPI Registry.