NPIMap

Organization Active NPI

Centro de Salud de la Comunidad de San Ysidro, Inc.

Doing business as San Ysidro Health National City

  • Federally Qualified Health Center (FQHC)
  • National City, CA
National Provider Identifier
1003869363
Registry record updated Oct 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
License
090000218 Issued in CA
Legal business name
CENTRO DE SALUD DE LA COMUNIDAD DE SAN YSIDRO, INC.
Doing business as
San Ysidro Health National City
San Ysidro Health National City Family Clinic
Practice address
1136 D Avenue
National City, CA 91950
Phone
(619) 336-2300
Fax
(619) 336-2323
NPI assigned
May 18, 2006
Last updated
Oct 2, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 2, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Kevin Mattson
Title
President/Ceo
Phone
(619) 662-4100

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X 090000218 CA Primary

Addresses

Primary practice location

1136 D Avenue
National City, CA 91950

Mailing address

1601 Precision Park LN
San Diego, CA 92173-1345
Phone (619) 662-4100

Other identifiers 1

IdentifierTypeStateIssuer
FHC70267FOtherCAMEDICAL

Other names 2

  • San Ysidro Health National City Doing business as
  • San Ysidro Health National City Family Clinic Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
O20040130000711 CA Part B Supplier - Clinic/Group Practice 6901709435 Receives reassigned benefits from 611 practitioners
41 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: National City, CA; San Diego, CA; San Ysidro, CA; Santee, CA; Vista, CA; Alpine, CA; Campo, CA; Chula Vista, CA…
O20051123000520 CA Part A Provider - Federally Qualified Health Center (FQHC) 6901709435 Practice locations: National City, CA
O20191023003400 CA MDPP Supplier - in-Person MDPP Supplier 6901709435 8 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: San Diego, CA; San Ysidro, CA; National City, CA; Chula Vista, CA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1003869363. Details of each certification follow.

Federally qualified health center certification: CCN 551810

Legal name
CENTRO DE SALUD DE LA COMUNIDAD DE SAN YSIDRO, INC.
Doing business as
SAN YSIDRO HEALTH NATIONAL CITY
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Sep 16, 1996
Last certification
Sep 16, 1996
Ownership / control type
For profit – partnership
Organization structure
CorporationNon-profit
Incorporated
Feb 5, 1971 in CA
Enrollment address
1136 D Ave
National City, CA 91950-3412

Other NPIs on the same Medicare enrollment 40

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 40

National Provider Directory

National Provider Directory

Locations

1620 Alpine Blvd
Ste 100
Alpine, CA 91901

1058 Third Ave
Chula Vista, CA 91911

1061 Tierra del Rey
Ste 305
Chula Vista, CA 91910

1392 E Palomar St
Ste 501
Chula Vista, CA 91913
Phone (619) 271-4059

1800 Maxwell Rd
Chula Vista, CA 91911
Phone (619) 205-6349

333 H St
Ste 2080
Chula Vista, CA 91910

480 Fourth Ave
Ste 507
Chula Vista, CA 91910
Phone (619) 427-4426

480 Palomar St
Chula Vista, CA 91911
Phone (619) 407-4840

780 Bay Blvd
Chula Vista, CA 91910
Phone (619) 476-6322

2400 E 8th St
Ste A
National City, CA 91950
Phone (619) 267-4255

340 E 8th St
National City, CA 91950

601 E 14th St
National City, CA 91950

3025 Beyer Blvd
Ste E101
San Diego, CA 92154
Phone (619) 428-5533

8110 Birmingham Way
San Diego, CA 92123
Phone (858) 966-4003

3364 Beyer Blvd
#103
San Ysidro, CA 92173

220 Town Ctr Pkwy
Santee, CA 92071

Ownership & related parties

All disclosed owners & managing parties 13

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Tomas Urtasun Individual Corporate DirectorBoard Member Apr 1, 2010
Guillermo Gomez Individual Corporate DirectorBoard Member Oct 20, 2012
Magdalena Peraza Individual Corporate Director Sep 15, 1983
William Wallace Individual Corporate OfficerCfo Nov 1, 2019
Victor Nieto Individual Corporate Director Sep 15, 1983
Reynaldo Perez Individual Corporate Director Sep 15, 1983
Antonietta McGuirk Individual Corporate DirectorDirector of Revenue Cycle Oct 16, 2013
Terry Whitaker Individual Corporate Director Sep 15, 1983
Sergio Cuevas Individual W-2 Managing Employee Sep 15, 1983
Gloria Ramirez Individual Corporate Director Sep 15, 1983
Macario Gutierrez Individual Corporate Director Sep 15, 1983
Kevin Mattson Individual Corporate OfficerCeo/President Nov 30, 2005
Margarita Navarro Individual Corporate Director Sep 15, 1983

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

All facility ownership & control disclosures 6

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
San Ysidro Health CHC-Ocean ViewSan Diego, CA, CCN 551920 Federally qualified health center 5% Or Greater Direct Ownership Interest Aug 25, 2008
San Ysidro Health EuclidSan Diego, CA, CCN 551922 Federally qualified health center 5% Or Greater Direct Ownership Interest Aug 25, 2009
San Ysidro Health OtayChula Vista, CA, CCN 551966 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) Feb 5, 1971
San Ysidro Health San Diego Pace/Senior Health ServicesSan Ysidro, CA, CCN 751102 Federally qualified health center 5% Or Greater Direct Ownership Interest Sep 1, 2014
San Ysidro Health El Cajon/San Diego PaceEl Cajon, CA, CCN 751822 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) Dec 1, 2015
San Ysidro Health South BayNational City, CA, CCN 751950 Federally qualified health center 5% Or Greater Direct Ownership Interest (5%) Jun 1, 2016

Practitioners & affiliated clinicians

Practitioners 252

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 252

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1147910400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1759363200000",
    "number": "1003869363",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1601 PRECISION PARK LN",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921731345",
            "telephone_number": "619-662-4100",
            "fax_number": "619-428-7952"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1136 D AVENUE",
            "city": "NATIONAL CITY",
            "state": "CA",
            "postal_code": "91950",
            "telephone_number": "619-336-2300",
            "fax_number": "619-336-2323"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTRO DE SALUD DE LA COMUNIDAD DE SAN YSIDRO, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-18",
        "last_updated": "2025-10-02",
        "certification_date": "2025-10-02",
        "status": "A",
        "authorized_official_last_name": "MATTSON",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "619-662-4100"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "CA",
            "license": "090000218",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL",
            "identifier": "FHC70267F",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "San Ysidro Health National City",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "San Ysidro Health National City Family Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in National City, CA

Sources for this page

Verify at the official NPI Registry.