| Mountain Health & Community Services, Inc. | |
| 
					3291 Buckman Springs Rd Pine Valley CA 91962-4003  | |
| (619) 473-8601 | |
| (619) 478-2267 | 
| Full Name | Mountain Health & Community Services, Inc. | 
|---|---|
| Speciality | Clinic/center - Federally Qualified Health Center (fqhc) | 
| Location | 3291 Buckman Springs Rd, Pine Valley, California | 
| Authorized Official Name and Position | Judith Shaplin (CEO) | 
| Authorized Official Contact | 6194456200 | 
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. | 
| Mailing Address | Practice Location Address | 
|---|---|
| Mountain Health & Community Services, Inc. 31115 Highway 94 Campo CA 91906-3133 Ph: (619) 478-5254  | Mountain Health & Community Services, Inc. 3291 Buckman Springs Rd Pine Valley CA 91962-4003 Ph: (619) 473-8601  | 
| NPI Number | 1326229477 | 
|---|---|
| Provider Enumeration Date | 11/16/2007 | 
| Last Update Date | 05/08/2017 | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1326229477 | NPI | - | NPPES | 
| BCP03814F | Other | CA | STATE PROGRAM | 
| FHC03814F | Medicaid | CA | |
| HAP03814F | Other | CA | STATE PROGRAM | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | 090000135 (California) | Primary | 
Centro De Salud De La Comunidad De San Ysidro Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3291 Buckman Springs Rd, Pine Valley, CA 91962 Phone: 619-662-4100  |