# CENTRO DE SALUD DE LA COMMUNIDAD DE SAN YSIDRO, INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** San Ysidro Health Mobile Health Services 1G
- **Organization subpart:** No

## Provider details

- **NPI number:** 1003033234
- **Authorized official:** KEVIN MATTSON (PRESIDENT/CEO)
- **Authorized official phone:** (619) 662-4100

## Contact information

- **Practice address:** 4004 BEYER BLVD, SAN YSIDRO, CA 92173-2007
- **Practice address phone:** (619) 205-6331
- **Practice address fax:** (619) 428-7952
- **Mailing address:** 1601 PRECISION PARK LN, SAN DIEGO, CA 92173-1345
- **Mailing address phone:** (619) 662-4100
- **Mailing address fax:** (619) 428-7952

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QR1300X | Rural Health Clinic/Center | 550000116 | CA | Yes |

## Other

- **Enumeration date:** 04/19/2007
- **Last updated:** 11/06/2019