| Centro De Salud De La Comunidad De San Ysidro Inc | |
|
3291 Buckman Springs Rd Pine Valley CA 91962-4003 | |
| (619) 662-4100 | |
| Not Available |
| Full Name | Centro De Salud De La Comunidad De San Ysidro Inc |
|---|---|
| Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
| Location | 3291 Buckman Springs Rd, Pine Valley, California |
| Authorized Official Name and Position | William Brian Wallace (VP/CFO) |
| Authorized Official Contact | 6192056339 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Centro De Salud De La Comunidad De San Ysidro Inc 1601 Precision Park Ln San Diego CA 92173-1345 Ph: (619) 205-6349 | Centro De Salud De La Comunidad De San Ysidro Inc 3291 Buckman Springs Rd Pine Valley CA 91962-4003 Ph: (619) 662-4100 |
| NPI Number | 1770117814 |
|---|---|
| Provider Enumeration Date | 02/27/2020 |
| Last Update Date | 02/27/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1770117814 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
Mountain Health & Community Services, Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3291 Buckman Springs Rd, Pine Valley, CA 91962 Phone: 619-473-8601 Fax: 619-478-2267 |