Organization
CENTRO DE SALUD DE LA COMUNIDAD DE SAN YSIDRO INC
Active
Other names
San Ysidro Health Pharmacy Mountain Health
Organization subpart
No
Provider details
NPI number
Authorized official
KEVIN MATTSON (PRESIDENT & CEO)
(619) 662-4100
Entity
Organization
Contact information
Practice address
1388 BUCKMAN SPRINGS RD, CAMPO, CA 91906-2028
(619) 662-4100
Mailing address
1601 PRECISION PARK LN, SAN DIEGO, CA 92173-1345
(619) 662-4100
(619) 428-7952
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
—
—
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Enumeration date
09/08/2022
Last updated
09/23/2022
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