San Ysidro Health Sherman Heights | |
316 25th St San Diego CA 92102-3016 | |
(619) 662-4100 | |
Not Available |
Full Name | San Ysidro Health Sherman Heights |
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Speciality | Clinic/Center |
Location | 316 25th St, San Diego, California |
Authorized Official Name and Position | Kevin Mattson (PRESIDENT/CEO) |
Authorized Official Contact | 6196624100 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
San Ysidro Health Sherman Heights 1601 Precision Park Ln San Diego CA 92173-1345 Ph: (619) 662-4100 | San Ysidro Health Sherman Heights 316 25th St San Diego CA 92102-3016 Ph: (619) 662-4100 |
NPI Number | 1598308926 |
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Provider Enumeration Date | 10/17/2019 |
Last Update Date | 03/24/2022 |
Medicare PECOS PAC ID | 6901709435 |
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Medicare Enrollment ID | O20201117003231 |
Identifier | Type | State | Issuer |
---|---|---|---|
1598308926 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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