| Organization Name: | CENTRO DE SALUD DE LA COMUNIDAD DE SAN YSIDRO, INC. |
| NPI Number: | 1467536326 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | GILBERT FIMBRES (CFO) |
| Mailing Address: | 4004 Beyer Blvd San Ysidro |
| State: | CA US |
| Postal Code: | 921732007 |
| Phone Number: | 6196624100 |
| Fax Number: | 6194282625 |
| NPI Enumeration Date: | 10/25/2006 |
| NPI Last Update Date: | 06/18/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 3336C0002X |
| License Number: | PHY38200 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Suppliers |
| Taxonomy Classification: | Pharmacy |
| Taxonomy Specialization: | Clinic Pharmacy |
| Taxonomy Definition: | A pharmacy in a clinic, emergency room or hospital (outpatient) that dispenses medications to patients for self-administration under the supervision of a pharmacist. |