Organization · Type 2 NPI

Centro de Salud de la Comunidad de San Ysidro Inc

Community/Retail Pharmacy · Campo, CA

NPI number 1063133015 Active

Practice location

1388 Buckman Springs Rd
Campo, CA 91906-2028

Call (619) 662-4100 Map

Mailing address

1601 Precision Park Ln
San Diego, CA 92173-1345

Specialties and licenses

Taxonomy	Code	License
Federally Qualified Health Center (FQHC)	261QF0400X	None listed
Community/Retail Pharmacy Primary	3336C0003X	None listed

Community/Retail Pharmacy: A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other …

9 other providers at this address

NPI record

NPI: 1063133015
Entity type: Organization (Type 2)
Issued: Sep 8, 2022
Last updated: Sep 23, 2022
Status: Active

Other names

<unavail>
San Ysidro Health Pharmacy Mountain Health · doing business as
San Ysidro Health Pharmacy Mountain Health · doing business as

Authorized official

Kevin Mattson
President & CEO
(619) 662-4100

Verify this record

This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

Is this your record? How to update it.

About NPI 1063133015

Centro de Salud de la Comunidad de San Ysidro Inc's National Provider Identifier is 1063133015, issued on Sep 8, 2022. The primary taxonomy on file is Community/Retail Pharmacy (3336C0003X), and the practice location is in Campo, CA. The record was last updated on Sep 23, 2022.