CENTRO DE SALUD DE LA COMUNIDAD DE SAN YSIDRO INC. NPI 1922051812

NPI Information

NPI: 1922051812
Provider Name: CENTRO DE SALUD DE LA COMUNIDAD DE SAN YSIDRO, INC.

Doing Business As: SAN YSIDRO HEALTH OTAY

Classification: Clinic/Center - 261QF0400X
Entity Type: Organization

Specialization: Federally Qualified Health Center (FQHC)

Address:
1637 3RD AVE SUITE B, C, F, H & I
CHULA VISTA, CA
ZIP 91911
Phone: (619) 662-4100
Get Directions

CENTRO DE SALUD DE LA COMUNIDAD DE SAN YSIDRO, INC. is a federally qualified health center (fqhc) clinic center in Chula Vista, CA. CENTRO DE SALUD DE LA COMUNIDAD DE SAN YSIDRO, INC. NPI is 1922051812. The provider is registered as an organization entity type.
The provider Is Doing Business As San Ysidro Health Otay.

The provider's business location address is:

1637 3RD AVE SUITE B, C, F, H & I
CHULA VISTA, CA
ZIP 91911-823
Phone: (619) 662-4100
Fax: (619) 205-1376

The provider's authorized official is Kevin Mattson .
The authorized official title is President/ceo and has the following contact phone number (619) 662-4100.

The enumeration date for this NPI number is 5/19/2006 and was last updated on 3/16/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QF0400X	Clinic/Center	Federally Qualified Health Center (FQHC)	090000136	CALIFORNIA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	W5740C	OTHER	CALIFORNIA	NORIDIAN MEDICARE PART B
2	FHC11992H	MEDICAID	CALIFORNIA
3	551966	OTHER	CALIFORNIA	NGS MEDICARE PART A

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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