| NPI | 1205405123 |
|---|---|
| Doing Business As | SAN YSIDRO HEALTH CENTRAL PROCESSING CENTER |
| Entity Type | Organization |
| Authorized Contact | WILLIAM BRIAN WALLACE VP/CFO 619-662-4100 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy |
| Additional Taxonomies | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2021-06-24 |
| Last Update Date | 2021-06-24 |