| San Ysidro Health Clinic | |
|
348 State Road 4 San Ysidro NM 87053-0348 | |
| (505) 321-9935 | |
| (575) 289-2688 |
| Full Name | San Ysidro Health Clinic |
|---|---|
| Speciality | Clinic/center - Primary Care |
| Location | 348 State Road 4, San Ysidro, New Mexico |
| Authorized Official Name and Position | Paula M Enyeart (C0-DIRECTOR) |
| Authorized Official Contact | 5053219935 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| San Ysidro Health Clinic Po Box 1629 Cuba NM 87013-1629 Ph: (505) 321-9935 | San Ysidro Health Clinic 348 State Road 4 San Ysidro NM 87053-0348 Ph: (505) 321-9935 |
| NPI Number | 1053541409 |
|---|---|
| Provider Enumeration Date | 07/20/2009 |
| Last Update Date | 12/22/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053541409 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | R31220 (New Mexico) | Primary |
New Mexico Mountain Healthcare Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 348 St. Rd. 4, San Ysidro, NM 87053 Phone: 505-404-6048 |