GENERAL PHYSICIAN GROUP MULTI SPECIALTY
NPI 1164641965
Clinic/Center - Federally Qualified Health Center (FQHC) in San Ysidro, CA

Q: What is Centro De Salud De La Comunidad De San Ysidro, Inc.'s specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Federally Qualified Health Center (FQHC), with taxonomy code 261QF0400X.

Active since April 24, 2007

4004 BEYER BLVD, SAN YSIDRO, CA 92173(619) 662-4100(619) 428-7952 Get Directions Write a Review

NPPES record last updated: November 6, 2019. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Nov 6, 2019, Jun 10, 2019, Dec 27, 2018 and 2 more (5 updates tracked since 2017).

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About General Physician Group Multi Specialty NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

GENERAL PHYSICIAN GROUP MULTI SPECIALTY (NPI 1164641965) is a healthcare organization registered as a federally qualified health center (fqhc) in San Ysidro, California and active in the NPI registry since April 2007. The organization lists Kevin Mattson, President/ceo, as its authorized official.

NPPES Registry Identity

NPI1164641965

Entity TypeOrganization

Primary Taxonomy261QF0400X

Legal Business NameCENTRO DE SALUD DE LA COMUNIDAD DE SAN YSIDRO, INC.

Location Address4004 BEYER BLVDSan Ysidro, CA 92173-2007

Mailing Address1601 Precision Park LnSan Diego, CA 92173-1345 · (619) 662-4100 · Fax (619) 428-7952

Phone(619) 662-4100

Fax(619) 428-7952

Organization SubpartNo

Authorized OfficialKevin MattsonPresident/ceo · (619) 662-4100

Enumeration DateApril 24, 2007

Last NPPES UpdateNovember 6, 20195 updates tracked since enumeration

✔ NPI 1164641965 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Federally Qualified Health Center (FQHC)Ambulatory Health Care Facilities

Taxonomy Code261QF0400X

License✔ Licensed in CA · 090000140

4004 BEYER BLVD, San Ysidro, CA 92173

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Other Names 1

Doing Business AsGeneral Physician Group Multi Specialty

Other Identifiers 1

MedicaidGR0041510CA

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

CENTRO DE SALUD DE LA COMMUNIDAD DE SAN YSIDRO, INC

Clinic/Center (Rural Health)