Healthcare Provider Details

I. General information

NPI: 1629009097
Provider Name (Legal Business Name): EMANATE HEALTH MEDICAL CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/05/2006
Last Update Date: 01/09/2026
Certification Date: 01/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

210 W SAN BERNARDINO RD
COVINA CA
91723-1515
US

IV. Provider business mailing address

PO BOX 840149
LOS ANGELES CA
90084-0149
US

V. Phone/Fax

Practice location:
  • Phone: 626-331-7331
  • Fax:
Mailing address:
  • Phone: 626-331-7331
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State

VIII. Authorized Official

Name: ROGER SHARMA
Title or Position: EXECUTIVE VP/CFO
Credential:
Phone: 626-938-7595