NPIMap

Organization Active NPI

San Diego Pace, LLC

Doing business as San Diego PACE San Ysidro

  • PACE Provider Organization
  • San Ysidro, CA
National Provider Identifier
1326969817
Registry record updated Jul 22, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
PACE Provider OrganizationTaxonomy code 251T00000X
Legal business name
SAN DIEGO PACE, LLC
Doing business as
San Diego PACE San Ysidro
Practice address
3364 Beyer Blvd
San Ysidro, CA 92173-1322
Phone
(619) 662-4100
NPI assigned
Jul 22, 2026
Last updated
Jul 22, 2026By the provider in NPPES
Organization subpart
Yes
Parent organization
CENTRO DE SALUD DE LA COMUNIDAD DE SAN YSIDRO, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 22, 2026

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

Authorized official

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PACE Provider Organization 251T00000X NU Primary

Addresses

Primary practice location

3364 Beyer Blvd
San Ysidro, CA 92173-1322

Mailing address

8080 Dagget St
San Diego, CA 92111-2333
Phone (619) 662-4100

Other names 1

  • San Diego PACE San Ysidro Doing business as

National Provider Directory

National Provider Directory
Tax ID family
San Diego Pace LLC5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

Locations

3364 Beyer Blvd
San Ysidro, CA 92173
Phone (619) 205-4585

NPI Registry JSON

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

{
    "created_epoch": "1784678400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1784678400000",
    "number": "1326969817",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8080 DAGGET ST",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921112333",
            "telephone_number": "619-662-4100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3364 BEYER BLVD",
            "city": "SAN YSIDRO",
            "state": "CA",
            "postal_code": "921731322",
            "telephone_number": "619-662-4100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAN DIEGO PACE, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CENTRO DE SALUD DE LA COMUNIDAD DE SAN YSIDRO, INC.",
        "enumeration_date": "2026-07-22",
        "last_updated": "2026-07-22",
        "certification_date": "2026-07-22",
        "status": "A",
        "authorized_official_last_name": "MATTSON",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_title_or_position": "PRESIDENT AND CEO",
        "authorized_official_telephone_number": "619-662-4100"
    },
    "taxonomies": [
        {
            "code": "251T00000X",
            "taxonomy_group": "",
            "desc": "Program of All-Inclusive Care for the Elderly (PACE) Provider Organization",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "San Diego PACE San Ysidro",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in San Ysidro, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.