CENTRO DE SALUD DE LA COMUNIDAD DE SAN YSIDRO, INC. (NPI# 1912950882) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1912950882 |
| Entity Type | Organization |
| Organization Name | CENTRO DE SALUD DE LA COMUNIDAD DE SAN YSIDRO, INC. |
| Other Organization Name | CHULA VISTA FAMILY CLINIC |
| Practice Address |
865 3rd Avenue Suite #133 Chula Vista CA 91910 |
| Mailing Address |
1275 30th St San Diego CA 92154-3476 |
| Practice Telephone | 6196624100 |
| Practice Fax Number | 6194220134 |
| Mailing Telephone | 6196624100 |
| Mailing Fax Number | 6194287952 |
| Enumeration Date | 2006-05-19 |
| Last Update Date | 2020-02-26 |
| NPI Deactivation Date | 04/18/2016 |
| NPI Reactivation Date | 2016-12-06 |
| Authorized Official Name | MR. GILBERT FIMBRES (CFO) |
| Authorized Official Telephone | 6192056331 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
090000300 | CA | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | FHC70394F | 05 |
| Other Name | Type Code |
|---|---|
| Chula Vista Family Clinic | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851757215 | Centro De Salud De La Comunidad De San Ysidro, Inc. | Clinic/Center | 330-340 E. 8th St, National City, CA 91950-2312 | 2016-01-14 |
| 1568845741 | Centro De Salud De La Comunidad De San Ysidro, Inc. | Clinic/Center | 436 S Magnolia Ave Ste 101, El Cajon, CA 92020-5219 | 2015-07-07 |
| 1356750657 | Centro De Salud De La Comunidad De San Ysidro, Inc. | Clinic/Center | 1058 3rd Ave, Chula Vista, CA 91911-2009 | 2014-08-12 |
| 1265843122 | Centro De Salud De La Comunidad De San Ysidro, Inc. | Clinic/Center | 3364 Beyer Blvd, Suite #102 & #103, San Ysidro, CA 92173-1322 | 2014-05-14 |
| 1538262092 | Centro De Salud De La Comunidad De San Ysidro, Inc. | Clinic/Center | 950 S Euclid Ave, San Diego, CA 92114-6201 | 2006-09-07 |
| 1922051812 | Centro De Salud De La Comunidad De San Ysidro, Inc. | Clinic/Center | 1637 3rd Ave Ste B, Chula Vista, CA 91911-5823 | 2006-05-19 |
| 1003869363 | Centro De Salud De La Comunidad De San Ysidro, Inc. | Clinic/Center | 1136 D Avenue, National City, CA 91950 | 2006-05-18 |
| 1801438239 | Centro De Salud De La Comunidad De San Ysidro, Inc. | Clinic/Center | 255 N Ash St Ste 101, Escondido, CA 92027-3069 | 2019-10-17 |
| 1205477841 | Centro De Salud De La Comunidad De San Ysidro, Inc. | Clinic/Center | 4690 El Cajon Blvd, San Diego, CA 92115-4403 | 2019-10-04 |
| 1376184911 | Centro De Salud De La Comunidad De San Ysidro, Inc. | Clinic/Center | 120 Town Center Pkwy, Santee, CA 92071-5801 | 2019-10-04 |
| Street Address |
865 3RD AVENUE SUITE #133 |
| City | CHULA VISTA |
| State | CA |
| Zip Code | 91910 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346211554 | Eleni I Capetanakis | Pediatrics | 865 3rd Avenue, #101, Chula Vista, CA 91911 | 2006-01-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477194264 | Joshua Maurice Hayden | Dental Hygienist | 678 Thrid Ave, Chula Vista, CA 91910 | 2019-10-02 |
| 1255980504 | Samantha Bernaldo | Dental Hygienist | 668 Third Ave, Chula Vista, CA 91910 | 2019-09-10 |
| 1073179529 | Roshni Kakaiya | Student in an Organized Health Care Education/Training Program | 435 H Street, Cv112, Chula Vista, CA 91910 | 2019-05-09 |
| 1598232506 | Naria Le Mire | Dietitian, Registered | 288 Broadway #141a, Chula Vista, CA 91910 | 2018-10-28 |
| 1730676727 | Pei Chi Chain | Optometrist | 324 F Street., Chula Vista, CA 91910 | 2018-04-16 |
| 1104332741 | Teodoro David Pena | Dentist | 510 Broadway Ste 4-5, Chula Vista, CA 91910 | 2017-12-19 |
| 1538684865 | Camille Cooke | Counselor | 430 F. Street, Chula Vista, CA 91910 | 2017-08-08 |
| 1184146094 | Alexandra Lynn Scovill | Optometrist | Castillejos Eye Institute Medical Group, 342 F Street, Chula Vista, CA 91910 | 2017-07-12 |
| 1396270583 | Tam Trieu | Pharmacist | 555 Broaway Suite 1054, Chula Vista, CA 91910 | 2017-04-25 |
| 1548792815 | Sabrina Owens | Family Medicine | 499 H Street Cv112, Chula Vista, CA 91910 | 2017-03-28 |
| Find all providers in zip 91910 | ||||
| Taxonomy Code | 261QF0400X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Federally Qualified Health Center (FQHC) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366053167 | Centro De Salud De La Comunidad De San Ysidro, Inc | Clinic/Center | 333 H St Ste 2080, Chula Vista, CA 91910-5558 | 2020-08-14 |
| 1952925109 | Family Health Centers of San Diego, Inc | Clinic/Center | 333 H St Ste 2010, Chula Vista, CA 91910-5556 | 2020-06-03 |
| 1295228328 | Centro De Salud De La Comunidad De San Ysidro, Inc | Clinic/Center | 880 Third Ave Ste A, Chula Vista, CA 91911 | 2018-06-13 |
| 1356750657 | Centro De Salud De La Comunidad De San Ysidro, Inc. | Clinic/Center | 1058 3rd Ave, Chula Vista, CA 91911-2009 | 2014-08-12 |
| 1497178750 | Family Health Centers of San Diego | Clinic/Center | 352 E L St, Chula Vista, CA 91911-1523 | 2014-01-22 |
| 1922051812 | Centro De Salud De La Comunidad De San Ysidro, Inc. | Clinic/Center | 1637 3rd Ave Ste B, Chula Vista, CA 91911-5823 | 2006-05-19 |
| 1952915878 | Centro De Salud De La Comunidad De San Ysidro Inc | Clinic/Center | 880 3rd Ave, Chula Vista, CA 91911-1305 | 2020-09-08 |
| 1376195040 | Centro De Salud De La Comunidad De San Ysidro, Inc. | Clinic/Center | 880 3rd Ave, Chula Vista, CA 91911-1305 | 2019-07-12 |
| 1184135873 | Centro De Salud De La Comunidad De San Ysidro, Inc | Clinic/Center | 855 3rd Ave Ste 2200, Chula Vista, CA 91911-1353 | 2017-10-20 |
| 1023462066 | Family Health Centers of San Diego Inc | Clinic/Center | 248 Landis Ave, Chula Vista, CA 91910-2609 | 2016-04-15 |
| Find all providers in CHULA VISTA | ||||
| City | CHULA VISTA |
| Zip Code | 91910 |
Please comment or provide details below to improve the information on CENTRO DE SALUD DE LA COMUNIDAD DE SAN YSIDRO, INC..
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.