CENTRO DE SALUD DE LA COMUNIDAD DE SAN YSIDRO, INC. (NPI# 1265843122) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1265843122 |
| Entity Type | Organization |
| Organization Name | CENTRO DE SALUD DE LA COMUNIDAD DE SAN YSIDRO, INC. |
| Other Organization Name | SAN YSIDRO SENIOR HEALTH CENTER |
| Practice Address |
3364 Beyer Blvd Suite #102 & #103 San Ysidro CA 92173-1322 |
| Mailing Address |
1601 Precision Park Ln San Diego CA 92173-1345 |
| Practice Telephone | 6196624100 |
| Practice Fax Number | 6196004867 |
| Mailing Telephone | 6196624100 |
| Mailing Fax Number | 6194287952 |
| Enumeration Date | 2014-05-14 |
| Last Update Date | 2019-11-06 |
| Authorized Official Name | KEVIN MATTSON (PRESIDENT/CEO) |
| Authorized Official Telephone | 6196624100 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| San Ysidro Senior Health Center | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851757215 | Centro De Salud De La Comunidad De San Ysidro, Inc. | Clinic/Center | 330-340 E. 8th St, National City, CA 91950-2312 | 2016-01-14 |
| 1568845741 | Centro De Salud De La Comunidad De San Ysidro, Inc. | Clinic/Center | 436 S Magnolia Ave Ste 101, El Cajon, CA 92020-5219 | 2015-07-07 |
| 1356750657 | Centro De Salud De La Comunidad De San Ysidro, Inc. | Clinic/Center | 1058 3rd Ave, Chula Vista, CA 91911-2009 | 2014-08-12 |
| 1538262092 | Centro De Salud De La Comunidad De San Ysidro, Inc. | Clinic/Center | 950 S Euclid Ave, San Diego, CA 92114-6201 | 2006-09-07 |
| 1922051812 | Centro De Salud De La Comunidad De San Ysidro, Inc. | Clinic/Center | 1637 3rd Ave Ste B, Chula Vista, CA 91911-5823 | 2006-05-19 |
| 1003869363 | Centro De Salud De La Comunidad De San Ysidro, Inc. | Clinic/Center | 1136 D Avenue, National City, CA 91950 | 2006-05-18 |
| 1801438239 | Centro De Salud De La Comunidad De San Ysidro, Inc. | Clinic/Center | 255 N Ash St Ste 101, Escondido, CA 92027-3069 | 2019-10-17 |
| 1205477841 | Centro De Salud De La Comunidad De San Ysidro, Inc. | Clinic/Center | 4690 El Cajon Blvd, San Diego, CA 92115-4403 | 2019-10-04 |
| 1376184911 | Centro De Salud De La Comunidad De San Ysidro, Inc. | Clinic/Center | 120 Town Center Pkwy, Santee, CA 92071-5801 | 2019-10-04 |
| 1174164719 | Centro De Salud De La Comunidad De San Ysidro, Inc. | Clinic/Center | 1388 Buckman Springs Rd, Campo, CA 91906-2028 | 2019-10-04 |
| Street Address |
3364 BEYER BLVD SUITE #102 & #103 |
| City | SAN YSIDRO |
| State | CA |
| Zip Code | 92173-1322 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265045991 | Balwinder K Shukla | Nurse Practitioner | 3364 Beyer Blvd, San Ysidro, CA 92173-1322 | 2020-08-24 |
| 1538558978 | Centro De Salud De La Comunidad De San Ysidro, Inc. | Clinic/Center | 3364 Beyer Blvd, Suite 102, San Ysidro, CA 92173-1322 | 2015-01-22 |
| 1386972248 | Centro De Salud De La Comunidad De San Ysidro,inc | Custodial Care Facility | 3364 Beyer Blvd, San Ysidro, CA 92173-1322 | 2009-12-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740707595 | Edith Gisel Herrera | Specialist/Technologist | 2370 Smythe Avenue #8, San Ysidro, CA 92173 | 2017-08-23 |
| 1508286709 | Negin Rajaipour | Family Medicine | 1601 Precision Park Ln, San Ysidro, CA 92173 | 2014-04-26 |
| 1962588376 | Jose Maria Alanis Amezcua | Obstetrics & Gynecology | 185 West San Ysidro Blvd, San Ysidro, CA 92173 | 2006-10-27 |
| 1346251535 | Yadira L Gamez | Dentist | 2004 Dairy Mart Rd, Ste 120, San Ysidro, CA 92173 | 2006-08-11 |
| 1558852947 | Centro De Salud De La Comunidad De San Ysidro Inc | Clinic/Center | 4050 Beyer Blvd, San Ysidro, CA 92173 | 2018-05-22 |
| 1194065813 | Diana Aguilar | Social Worker | 4004 Beyer Blvd, San Ysidro, CA 92173 | 2013-02-15 |
| 1710292248 | Nassera L Saidani | Physician Assistant | 4004 Beyer Blvd, San Ysidro, CA 92173 | 2010-08-09 |
| 1467536326 | Centro De Salud De La Comunidad De San Ysidro, Inc. | Pharmacy | 4004 Beyer Blvd, San Ysidro, CA 92173 | 2006-10-25 |
| 1871506378 | Clarissa A Castillo | Physician Assistant | 4004 Beyer Blvd, San Ysidro, CA 92173 | 2006-08-14 |
| 1992777882 | Elena Maria Bautista Sacamay | Internal Medicine | 4004 Beyer Blvd, San Ysidro, CA 92173 | 2006-02-03 |
| Find all providers in zip 92173 | ||||
| Taxonomy Code | 261QF0400X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Federally Qualified Health Center (FQHC) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558852947 | Centro De Salud De La Comunidad De San Ysidro Inc | Clinic/Center | 4050 Beyer Blvd, San Ysidro, CA 92173 | 2018-05-22 |
| 1538558978 | Centro De Salud De La Comunidad De San Ysidro, Inc. | Clinic/Center | 3364 Beyer Blvd, Suite 102, San Ysidro, CA 92173-1322 | 2015-01-22 |
| 1164641965 | Centro De Salud De La Comunidad De San Ysidro, Inc. | Clinic/Center | 4004 Beyer Blvd, San Ysidro, CA 92173-2007 | 2007-04-24 |
| 1952364747 | Centro De Salud De La Comunidad De San Ysidro, Inc. | Clinic/Center | 4004 Beyer Blvd, San Ysidro, CA 92173-2007 | 2006-04-11 |
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| Find all providers with the same taxonomy | ||||
| City | SAN YSIDRO |
| Zip Code | 92173 |
Please comment or provide details below to improve the information on CENTRO DE SALUD DE LA COMUNIDAD DE SAN YSIDRO, INC..
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.