| Centro De Salud De La Comunidad De San Ysidro, Inc. | |
|
2721 Washington St Julian CA 92036-9233 | |
| (619) 662-4100 | |
| Not Available |
| Full Name | Centro De Salud De La Comunidad De San Ysidro, Inc. |
|---|---|
| Speciality | Clinic/Center |
| Location | 2721 Washington St, Julian, California |
| Authorized Official Name and Position | William Brian Wallace (CFO) |
| Authorized Official Contact | 6192056339 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Centro De Salud De La Comunidad De San Ysidro, Inc. 1601 Precision Park Ln San Diego CA 92173-1345 Ph: (619) 662-4100 | Centro De Salud De La Comunidad De San Ysidro, Inc. 2721 Washington St Julian CA 92036-9233 Ph: (619) 662-4100 |
| NPI Number | 1235804139 |
|---|---|
| Provider Enumeration Date | 08/12/2021 |
| Last Update Date | 08/12/2021 |
| Medicare PECOS PAC ID | 6901709435 |
|---|---|
| Medicare Enrollment ID | O20211116002997 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1235804139 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
Centro De Salud De La Comunidad De San Ysidro, Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2602 Washington Street, Julian, CA 92036 Phone: 619-662-4100 |