| Centro De Salud De La Comunidad De San Ysidro, Inc. | |
|
2602 Washington Street Julian CA 92036 | |
| (619) 662-4100 | |
| Not Available |
| Full Name | Centro De Salud De La Comunidad De San Ysidro, Inc. |
|---|---|
| Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
| Location | 2602 Washington Street, Julian, California |
| Authorized Official Name and Position | Kevin Mattson (PRESIDENT/CFO) |
| Authorized Official Contact | 6196624100 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| 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. 2602 Washington Street Julian CA 92036 Ph: (619) 662-4100 |
| NPI Number | 1730893777 |
|---|---|
| Provider Enumeration Date | 01/12/2023 |
| Last Update Date | 01/12/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1730893777 | 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: Medicare Enrolled Practice Location: 2721 Washington St, Julian, CA 92036 Phone: 619-662-4100 |