Organization
CENTRO DE SALUD DE LA COMUNIDAD DE SAN YSIDRO INC
Active
Other names
San Ysidro Mountain Empire School Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
WILLIAM BRIAN WALLACE (VP/CFO)
(619) 205-6339
Entity
Organization
Contact information
Practice address
3291 BUCKMAN SPRINGS RD, PINE VALLEY, CA 91962-4003
(619) 662-4100
Mailing address
1601 PRECISION PARK LN, SAN DIEGO, CA 92173-1345
(619) 205-6349
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Enumeration date
02/27/2020
Last updated
02/27/2020
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