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Export Provider Record NPI 1124782685
Centro De Salud De La Comunidad De San Ysidro, Inc.
Organization Subpart: NO
Active
NPI Number1124782685
NPI TypeNPI-2 Organization
SpecialtyClinic/Center, Federally Qualified Health Center (FQHC)
Provider Details
NPI1124782685
NPI TypeNPI-2 Organization
StatusActive
Enumeration Date2021-10-29
Last Updated2022-11-18
Authorized OfficialWilliam Wallace
VP/CFO
Phone: 6192056339
Mailing Address1601 Precision Park Ln
San Diego, CA 92173-1345
United States
Phone: (619) 662-4100
📍 View Map
Primary Practice Address1666 Precision Park Ln
San Diego, CA 92173-1346
United States
Phone: (619) 662-4100
📍 View Map
Taxonomy / Specialty
PrimaryTaxonomy Code & DescriptionStateLicense Number
Yes261QF0400X – Clinic/Center, Federally Qualified Health Center (FQHC)
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About NPI 1124782685

Centro De Salud De La Comunidad De San Ysidro, Inc. is an organization registered in the CMS NPPES NPI Registry with NPI number 1124782685. The primary specialty listed is Clinic/Center, Federally Qualified Health Center (FQHC). The organization is located in San Diego, CA. This NPI is classified as a Type 2 (Organizational) NPI and is currently active. The NPI was first enumerated (assigned) on 2021-10-29. All data is sourced directly from the official CMS NPPES public API and is updated daily.

Frequently Asked Questions

What is NPI 1124782685?

NPI 1124782685 belongs to Centro De Salud De La Comunidad De San Ysidro, Inc., a Clinic/Center, Federally Qualified Health Center (FQHC) in San Diego, CA. It is a Type 2 Organizational NPI registered in the CMS NPPES NPI Registry.

Is NPI 1124782685 active?

The current status of NPI 1124782685 in the NPPES registry is Active. The record was last updated on 2022-11-18.

What specialty is NPI 1124782685?

NPI 1124782685 is classified under the taxonomy Clinic/Center, Federally Qualified Health Center (FQHC). Taxonomy codes in NPPES are maintained by the National Uniform Claim Committee (NUCC) and identify the provider's type, classification, and specialization.

How do I verify NPI 1124782685?

You can verify NPI 1124782685 at the official CMS NPPES website at npiregistry.cms.hhs.gov or using our free NPI Lookup tool above. All data shown on this page is sourced directly from the official NPPES public API and is updated daily by CMS.

What address is on file for NPI 1124782685?

The primary practice address on file for NPI 1124782685 is 1666 Precision Park Ln, San Diego, CA 92173-1346. This address is registered in the NPPES system and providers are required to update it within 30 days of any change.

When was NPI 1124782685 issued?

NPI 1124782685 was first issued (enumerated) on 2021-10-29. The NPPES record was last updated on 2022-11-18.

Practice Location Map

Centro De Salud De La Comunidad De San Ysidro, Inc. is located at 1666 Precision Park Ln, San Diego, CA. Use the map below to find directions or verify the practice location.

📍 1666 Precision Park Ln, San Diego, CA 92173-1346  ·  Open in Google Maps ↗

Related Healthcare Providers

The following providers share the same practice location, specialty, or state as Centro De Salud De La Comunidad De San Ysidro, Inc.. All records sourced from the CMS NPPES registry.

Data Verified from CMS NPPES Last synced: 2026-06-30 · Source: npiregistry.cms.hhs.gov · 45 CFR Part 162