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General NPI Number Information
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NPI Number | 1669507620
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Entity Type | Organization
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Legal Business Name | EMANATE HEALTH MEDICAL CENTER
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Dates
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Enumeration Date | 02/22/2007
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Last Update Date | 10/27/2020
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Provider Practice Location Address
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Address Line | 210 W SAN BERNARDINO RD
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City | COVINA
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State | CA
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Zip | 91723-1515
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Country | US
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Telephone | 626-915-6273
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Fax | 626-859-5887
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Provider Business Mailing Address
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Address Line | 210 W SAN BERNARDINO RD P.O. BOX 6108
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City | COVINA
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State | CA
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Zip | 91723-1515
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Country | US
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Telephone | 626-915-6273
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Fax | 626-859-5887
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Authorized Official
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Title or Position | EXECUTIVE VP/CFO
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Name | ROGER SHARMA
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Credential |
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Telephone | 626-938-7595
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 282N00000X
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Taxonomy Name | General Acute Care Hospital
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 282N00000X
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Taxonomy Name | General Acute Care Hospital
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License Number | HSP43961
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License Number State | CA
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