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CH09108AP 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
ALPINE FAMILY MEDICINE
Type
HRSA-Funded Health Center
Site ID
BPS-H80-030969
340B ID
CH09108AP
Grant Number
H80CS10748
Additional Details
Current Program Status
Active
Registration Date
7/15/2020
Participating Start Date
10/1/2020
Participating Approval Date
7/21/2020
Last Recertification Date
2/24/2025
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
1620 Alpine Blvd STE B119
Alpine, CA 91901
Billing Address
San Ysidro Health Center
4004 Beyer Blvd
San Ysidro, CA 92173
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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April 2025
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