| San Ysidro Health San Ysidro Health Center | |
|
4004 Beyer Blvd San Ysidro CA 92173-2007 | |
| (619) 662-4100 | |
| (619) 205-6373 |
| Full Name | San Ysidro Health San Ysidro Health Center |
|---|---|
| Speciality | Clinic/Center |
| Location | 4004 Beyer Blvd, San Ysidro, California |
| Authorized Official Name and Position | Kevin Mattson (PRESIDENT AND 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 San Ysidro Health Center 1601 Precision Park Ln San Diego CA 92173-1345 Ph: (619) 662-4100 | San Ysidro Health San Ysidro Health Center 4004 Beyer Blvd San Ysidro CA 92173-2007 Ph: (619) 662-4100 |
| NPI Number | 1952364747 |
|---|---|
| Provider Enumeration Date | 04/11/2006 |
| Last Update Date | 05/08/2019 |
| Medicare PECOS PAC ID | 6901709435 |
|---|---|
| Medicare Enrollment ID | O20051123000458 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1952364747 | NPI | - | NPPES |
| FHC18880F | Other | CA | MEDICAL |
| W5740 | Other | MEDICARE PTAN PART B |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | 090000140 (California) | Primary |
San Ysidro Health Mobile Health Services 1g Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 4004 Beyer Blvd, San Ysidro, CA 92173 Phone: 619-205-6331 Fax: 619-428-7952 | |
Healthcare Providers Of California Medical Group, Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 342 W San Ysidro Blvd, #f, San Ysidro, CA 92173 Phone: 619-662-3880 Fax: 619-662-2942 | |
General Physician Group Multi Specialty Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 4004 Beyer Blvd, San Ysidro, CA 92173 Phone: 619-662-4100 Fax: 619-428-7952 | |
Centro De Salud De La Comunidad De San Ysidro, Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 4004 Beyer Blvd, San Ysidro, CA 92173 Phone: 619-662-4100 | |
Centro De Salud De La Comunidad De San Ysidro, Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 4004 Beyer Blvd, San Ysidro, CA 92173 Phone: 619-662-4100 | |
San Ysidro Health San Diego Pace/senior Health Services Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 3364 Beyer Blvd, Suite #102 & #103, San Ysidro, CA 92173 Phone: 619-662-4100 Fax: 619-600-4867 | |
San Ysidro Health Mobile Health Services 1f Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 4004 Beyer Blvd, San Ysidro, CA 92173 Phone: 619-662-4100 Fax: 619-205-6373 |