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CH09108A 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 National City
Type
HRSA-Funded Health Center
Site ID
BPS-H80-001683
340B ID
CH09108A
Grant Number
H80CS10748
Additional Details
Current Program Status
Active
Registration Date
4/1/1995
Participating Start Date
4/1/1995
Participating Approval Date
3/25/2005
Last Recertification Date
3/5/2025
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
1136 D Ave
National City, CA 91950-3412
Billing Address
SAN YSIDRO HEALTH CENTER, INC
4004 Beyer Blvd
San Ysidro, CA 92173
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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2/9/09 - KB - GRANT NUMBER CHANGED (FORMER #H80CS00227)
02/09/2009
April 2025
April 2025
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