NPIMap

Organization Active NPI

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

Doing business as South Bay Family Health Center

  • Urgent Care Clinic/Center
  • Chula Vista, CA
National Provider Identifier
1184801433
Registry record updated May 6, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urgent Care Clinic/CenterTaxonomy code 261QU0200X
License
550000782 Issued in CA
Legal business name
CENTRO DE SALUD DE LA COMUNIDAD DE SAN YSIDRO,INC.
Doing business as
South Bay Family Health Center
Practice address
340 4TH Ave Ste 6&7
Chula Vista, CA 91910-3813
Phone
(619) 662-4100
Fax
(619) 428-7952
NPI assigned
Jan 29, 2008
Last updated
May 6, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 6, 2014

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

Authorized official

Name
Gilbert Fimbres
Title
Cfo
Phone
(619) 205-6331

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urgent Care Clinic/Center 261QU0200X 550000782 CA Primary

Addresses

Primary practice location

340 4TH Ave Ste 6&7
Chula Vista, CA 91910-3813

Mailing address

1275 30TH St
San Diego, CA 92154-3476
Phone (619) 662-4100

Other names 1

  • South Bay Family Health Center Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

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…

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

340 Fourth Ave
Ste 67
Chula Vista, CA 91910

NPI Registry JSON

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

{
    "created_epoch": "1201564800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1399334400000",
    "number": "1184801433",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1275 30TH ST",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921543476",
            "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": "340 4TH AVE STE 6&7",
            "city": "CHULA VISTA",
            "state": "CA",
            "postal_code": "919103813",
            "telephone_number": "619-662-4100",
            "fax_number": "619-428-7952"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTRO DE SALUD DE LA COMUNIDAD DE SAN YSIDRO,INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-29",
        "last_updated": "2014-05-06",
        "status": "A",
        "authorized_official_last_name": "FIMBRES",
        "authorized_official_first_name": "GILBERT",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "619-205-6331"
    },
    "taxonomies": [
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": "CA",
            "license": "550000782",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "South Bay Family Health Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Chula Vista, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.