| San Ysidro Health King-chavez Health Center | |
|
950 S Euclid Ave San Diego CA 92114-6201 | |
| (619) 662-4100 | |
| (619) 428-7952 |
| Full Name | San Ysidro Health King-chavez Health Center |
|---|---|
| Speciality | Clinic/Center |
| Location | 950 S Euclid Ave, 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 King-chavez Health Center 1601 Precision Park Ln San Diego CA 92173-1345 Ph: (619) 662-4100 | San Ysidro Health King-chavez Health Center 950 S Euclid Ave San Diego CA 92114-6201 Ph: (619) 662-4100 |
| NPI Number | 1538262092 |
|---|---|
| Provider Enumeration Date | 09/07/2006 |
| Last Update Date | 11/06/2019 |
| Medicare PECOS PAC ID | 6901709435 |
|---|---|
| Medicare Enrollment ID | O20130215000473 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1538262092 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | 090000660 (California) | Primary |
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