Centro De Salud De La Comunidad De San Ysidro, Inc.
NPI 1124782685 · Federally Qualified Health Center (FQHC) · San Diego, CA
Enrolled with Medicare as Part a Provider - Federally Qualified Health Center (fqhc) · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Provider details
- NPI number
- 1124782685
- Entity type
- Organization
- Primary specialty
- Federally Qualified Health Center (FQHC)Ambulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- William Wallace, Vp/Cfo(619) 205-6339
Specialties & taxonomies
Ambulatory Health Care Facilities
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
4 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Other names (DBA / former)
- Doing business as
- San Ysidro Health Precision Park
Registry dates
- Enumerated
- 2021-10-29
- Last updated
- 2022-11-18
- Certified
- 2022-11-18
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.