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CH09114D SAN MATEO MEDICAL CENTER (Active)
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Main Details
Name
SAN MATEO MEDICAL CENTER
Subdivision Name
DALY CITY YOUTH HEALTH CENTER
Type
HRSA-Funded Health Center
Site ID
BPS-H80-022195
340B ID
CH09114D
Grant Number
H80CS00051
Additional Details
Current Program Status
Active
Registration Date
10/1/2001
Participating Start Date
10/1/2001
Participating Approval Date
11/9/2004
Last Recertification Date
3/5/2025
Contacts
Authorizing Official
San Mateo Medical Center
CHESTER J. KUNNAPPILLY, CEO
(650) 573-2305
Primary Contact
San Mateo Medical Center
Victor Armendariz, Director of Pharmacy
(650) 573-2366
Addresses
Street Address
350 90th St
DALY CITY, CA 94015
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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11/9/04 - ADMIN CORRECTION - REPLACES HO091140A
10/01/2001
May 2025
May 2025
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