CENTRO DE SALUD DE LA COMUNIDAD DE SAN YSIDRO, INC.

NPI # 

Practice Address:

865 3Rd Avenue , Suite #133

Chula Vista, CA, 91910

Practice Phone:

619-662-4100

Practice Fax:

619-422-0134

License Number:

090000300

License State:

CA

Taxonomy Grouping:

Ambulatory Health Care Facilities

Taxonomy Classification:

Clinic/Center

Taxonomy Specialization:

Federally Qualified Health Center (FQHC)

Taxonomy Code:

261QF0400X

Deactivation Date:

2016-04-18T00:00:00.000Z

Deactivation Code:

None

Reactivation Date:

2016-12-06T00:00:00.000Z