Organization
CENTRO DE SALUD DE LA COMUNIDAD DE SAN YSIDRO INC
Active
Other names
San Ysidro Health Senior Dental Center
Organization subpart
No
Provider details
NPI number
Authorized official
KEVIN MATTSON (PRESIDENT/CEO)
(619) 662-4100
Entity
Organization
Contact information
Practice address
1525 FOURTH AVE, 2ND FLOOR, SAN DIEGO, CA 92101-3107
(619) 662-4100
Mailing address
1601 PRECISION PARK LN, SAN DIEGO, CA 92173-1345
(619) 662-4100
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Enumeration date
08/04/2023
Last updated
10/06/2023
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