| NPI | 1902587298 |
|---|---|
| Doing Business As | SAN YSIDRO HEALTH WELLNESS CLINIC |
| Entity Type | Organization |
| Authorized Contact | KEVIN MATTSON President/CEO 619-662-4100 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2023-07-28 |
| Last Update Date | 2024-01-11 |