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FP921132 Centro de Salud de la Comunidad de San Ysidro, Inc. (Active)
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Main Details
Name
Centro de Salud de la Comunidad de San Ysidro, Inc.
Subdivision Name
San Ysidro Health CHC - Ocean View
Type
Family Planning (Title X only)
340B ID
FP921132
Grant Number
FPHPA096061
Additional Details
Current Program Status
Active
Registration Date
3/22/2012
Participating Start Date
7/1/2012
Participating Approval Date
6/13/2012
Last Recertification Date
5/13/2024
Contacts
Authorizing Official
Centro de Salud de la Comunidad de San Ysidro, Inc.
Brian Wallace, VP of Finance & CFO
(619) 662-4100
Primary Contact
Centro de Salud de la Comunidad de San Ysidro Inc.
Douglas Israel, Director of Contracts
(619) 662-4165
Addresses
Street Address
3177 Ocean View
San Diego, CA 92113
Billing Address
San Ysidro Health Center, Inc.
4004 Beyer Blvd.
San Ysidro, CA 92173
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
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