NPI 1174213904

Centro de Salud de La Comunidad de San Ysidro, INC.

Organisation Federally Qualified Health Center (FQHC) San Ysidro, CA

Practice location

Address: 4004 Beyer Blvd, San Ysidro, CA 92173-2007
Phone: (619) 662-4100
Mailing address: 1601 Precision Park Ln, San Diego, CA 92173-1345

Authorised official

Name: Kevin Mattson
Title: President/Ceo
Phone: (619) 662-4100

Registered specialties

Federally Qualified Health Center (FQHC) Primary

Ambulatory Health Care Facilities Taxonomy 261QF0400X

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Registry record

NPI: 1174213904
Entity type: Organization
NPI issued: 15 May 2023
Record last updated: 15 May 2023

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.