Organization
CENTRO DE SALUD DE LA COMUNIDAD DE SAN YSIDRO INC
Active
Other names
San Ysidro Health Our Place
Organization subpart
No
Provider details
NPI number
Authorized official
WILLIAM BRIAN WALLACE (VP/CFO)
(619) 205-6339
Entity
Organization
Contact information
Practice address
286 EUCLID AVE STE 309, SAN DIEGO, CA 92114-3613
(619) 662-4100
(619) 428-7952
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)
Primary
—
—
Other
Enumeration date
09/28/2022
Last updated
09/28/2022
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