Organization
CENTRO DE SALUD DE LA COMUNIDAD DE SAN YSIDRO, INC.
Active
Other names
San Ysidro Health Children's Dental Center at Rady Children's Hospital
Organization subpart
No
Provider details
NPI number
Authorized official
KEVIN MATTSON (PRESIDENT AND CEO)
(619) 662-4100
Entity
Organization
Contact information
Practice address
8110 BIRMINGHAM WAY, SAN DIEGO, CA 92123
(619) 662-4100
(619) 205-6373
Mailing address
1601 PRECISION PARK LN, SAN DIEGO, CA 92173-1345
(619) 662-4100
(619) 428-7952
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
550000692
CA
Other
Enumeration date
01/29/2008
Last updated
11/06/2018
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