Centro de Salud de la Comunidad de San Ysidro, Inc.
NPI 1124793732ActiveOrganization· PACE Provider Organization· Vista, CA
PACE Provider Organization in Vista, California, registered in NPPES in August 2021, part of Centro de Salud de la Comunidad de San Ysidro, Inc. The authorized official on file is Kevin Mattson, President/Ceo. Enrolled in Medicare as part a provider - federally qualified health center (fqhc).
Overview
| NPI | 1124793732 |
|---|---|
| Status | Active |
| Entity type | Organization (subpart) |
| Parent organization | Centro de Salud de la Comunidad de San Ysidro, Inc. |
| NPI issued | Aug 16, 2021 |
| Last updated in NPPES | Jan 27, 2026 |
| Certified by provider | Jan 27, 2026 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| PACE Provider Organization Primary | 251T00000X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part A Provider - Federally Qualified Health Center (FQHC) (CA) |
|---|
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