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Organization

CENTRO DE SALUD DE LA COMUNIDAD DE SAN YSIDRO INC

Active
Other names
San Ysidro Health Central Processing Center
Organization subpart
No

Provider details

NPI number
Authorized official
WILLIAM BRIAN WALLACE (VP/CFO)
(619) 662-4100
Entity
Organization

Contact information

Practice address
1660 PRECISION PARK LN, SAN DIEGO, CA 92173-1346
(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
06/24/2021
Last updated
06/24/2021
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