NPI Code Detail XML Logo

1164641965 NPI number — CENTRO DE SALUD DE LA COMUNIDAD DE SAN YSIDRO, INC.

NPI Number: 1164641965
Health Care Provider/Practitioner: CENTRO DE SALUD DE LA COMUNIDAD DE SAN YSIDRO, INC.

Information about “1164641965” NPI (CENTRO DE SALUD DE LA COMUNIDAD DE SAN YSIDRO, INC.) exists in 1164641965 in HTML format HTML  |  1164641965 in plain Text format TXT  |  1164641965 in PDF (Portable Document Format) PDF  |  1164641965 in an JSON format JSON  formats.

NPI Number : 1164641965 – XML Data Format 

                    
<?xml version="1.0" encoding="UTF-8"?>
<Npi>
	<NPI>
		1164641965
	</NPI>
	<EntityType>
		Organization
	</EntityType>
	<ReplacementNPI/>
	<EIN/>
	<IsSoleProprietor/>
	<IsOrgSubpart>
		N
	</IsOrgSubpart>
	<ParentOrgLBN/>
	<ParentOrgTIN/>
	<OrgName>
		CENTRO DE SALUD DE LA COMUNIDAD DE SAN YSIDRO, INC.
	</OrgName>
	<LastName/>
	<FirstName/>
	<MiddleName/>
	<NamePrefix/>
	<NameSuffix/>
	<Credential/>
	<OtherOrgName/>
	<OtherOrgNameTypeCode>
		6
	</OtherOrgNameTypeCode>
	<OtherLastName/>
	<OtherFirstName/>
	<OtherMiddleName/>
	<OtherNamePrefix/>
	<OtherNameSuffix/>
	<OtherCredential/>
	<OtherLastNameTypeCode/>
	<FirstLineMailingAddress>
		1601 PRECISION PARK LN
	</FirstLineMailingAddress>
	<SecondLineMailingAddress/>
	<MailingAddressCityName>
		SAN DIEGO
	</MailingAddressCityName>
	<MailingAddressStateName>
		CA
	</MailingAddressStateName>
	<MailingAddressPostalCode>
		92173-1345
	</MailingAddressPostalCode>
	<MailingAddressCountryCode>
		US
	</MailingAddressCountryCode>
	<MailingAddressTelephoneNumber>
		619-662-4100
	</MailingAddressTelephoneNumber>
	<MailingAddressFaxNumber>
		619-428-7952
	</MailingAddressFaxNumber>
	<FirstLinePracticeLocationAddress>
		4004 BEYER BLVD
	</FirstLinePracticeLocationAddress>
	<SecondLinePracticeLocationAddress/>
	<PracticeLocationAddressCityName>
		SAN YSIDRO
	</PracticeLocationAddressCityName>
	<PracticeLocationAddressStateName>
		CA
	</PracticeLocationAddressStateName>
	<PracticeLocationAddressPostalCode>
		92173-2007
	</PracticeLocationAddressPostalCode>
	<PracticeLocationAddressCountryCode>
		US
	</PracticeLocationAddressCountryCode>
	<PracticeLocationAddressTelephoneNumber>
		619-662-4100
	</PracticeLocationAddressTelephoneNumber>
	<PracticeLocationAddressFaxNumber>
		619-428-7952
	</PracticeLocationAddressFaxNumber>
	<EnumerationDate>
		04/24/2007
	</EnumerationDate>
	<LastUpdateDate>
		11/06/2019
	</LastUpdateDate>
	<NPIDeactivationReasonCode/>
	<NPIDeactivationReason/>
	<NPIDeactivationDate/>
	<NPIReactivationDate/>
	<GenderCode/>
	<Gender/>
	<AuthorizedOfficialLastName>
		MATTSON
	</AuthorizedOfficialLastName>
	<AuthorizedOfficialFirstName>
		KEVIN
	</AuthorizedOfficialFirstName>
	<AuthorizedOfficialMiddleName/>
	<AuthorizedOfficialTitle>
		PRESIDENT/CEO
	</AuthorizedOfficialTitle>
	<AuthorizedOfficialNamePrefix/>
	<AuthorizedOfficialNameSuffix/>
	<AuthorizedOfficialCredential/>
	<AuthorizedOfficialTelephoneNumber>
		619-662-4100
	</AuthorizedOfficialTelephoneNumber>
	<Taxonomies>
		<Taxonomy>
			<TaxonomyCode>
				261QF0400X
			</TaxonomyCode>
			<TaxonomyName>
				Federally Qualified Health Center (FQHC)
			</TaxonomyName>
			<LicenseNumber>
				090000140
			</LicenseNumber>
			<LicenseNumberStateCode>
				CA
			</LicenseNumberStateCode>
			<PrimaryTaxonomySwitch>
				Y
			</PrimaryTaxonomySwitch>
		</Taxonomy>
	</Taxonomies>
	<HealthcareProviderTaxonomyGroups/>
</Npi>

NPI Number XSD (XML Schema Definition)

                
<?xml version="1.0" encoding="UTF-8"?>
   <xs:schema xmlns:xs="http://www.w3.org/2001/XMLSchema" elementFormDefault="qualified" attributeFormDefault="unqualified">
         <xs:element name="Npi">
               <xs:complexType>
                     <xs:sequence>
                           <xs:element name="NPI" type="xs:int"></xs:element>
                           <xs:element name="EntityType" type="xs:string"></xs:element>
                           <xs:element name="ReplacementNPI"></xs:element>
                           <xs:element name="EIN"></xs:element>
                           <xs:element name="IsSoleProprietor" type="xs:string"></xs:element>
                           <xs:element name="IsOrgSubpart"></xs:element>
                           <xs:element name="ParentOrgLBN"></xs:element>
                           <xs:element name="ParentOrgTIN"></xs:element>
                           <xs:element name="OrgName"></xs:element>
                           <xs:element name="LastName" type="xs:string"></xs:element>
                           <xs:element name="FirstName" type="xs:string"></xs:element>
                           <xs:element name="MiddleName"></xs:element>
                           <xs:element name="NamePrefix" type="xs:string"></xs:element>
                           <xs:element name="NameSuffix"></xs:element>
                           <xs:element name="Credential" type="xs:string"></xs:element>
                           <xs:element name="OtherOrgName"></xs:element>
                           <xs:element name="OtherOrgNameTypeCode"></xs:element>
                           <xs:element name="OtherLastName"></xs:element>
                           <xs:element name="OtherFirstName"></xs:element>
                           <xs:element name="OtherMiddleName"></xs:element>
                           <xs:element name="OtherNamePrefix"></xs:element>
                           <xs:element name="OtherNameSuffix"></xs:element>
                           <xs:element name="OtherCredential"></xs:element>
                           <xs:element name="OtherLastNameTypeCode"></xs:element>
                           <xs:element name="FirstLineMailingAddress" type="xs:string"></xs:element>
                           <xs:element name="SecondLineMailingAddress"></xs:element>
                           <xs:element name="MailingAddressCityName" type="xs:string"></xs:element>
                           <xs:element name="MailingAddressStateName" type="xs:string"></xs:element>
                           <xs:element name="MailingAddressPostalCode" type="xs:string"></xs:element>
                           <xs:element name="MailingAddressCountryCode" type="xs:string"></xs:element>
                           <xs:element name="MailingAddressTelephoneNumber" type="xs:string"></xs:element>
                           <xs:element name="MailingAddressFaxNumber"></xs:element>
                           <xs:element name="FirstLinePracticeLocationAddress" type="xs:string"></xs:element>
                           <xs:element name="SecondLinePracticeLocationAddress" type="xs:string"></xs:element>
                           <xs:element name="PracticeLocationAddressCityName" type="xs:string"></xs:element>
                           <xs:element name="PracticeLocationAddressStateName" type="xs:string"></xs:element>
                           <xs:element name="PracticeLocationAddressPostalCode" type="xs:string"></xs:element>
                           <xs:element name="PracticeLocationAddressCountryCode" type="xs:string"></xs:element>
                           <xs:element name="PracticeLocationAddressTelephoneNumber" type="xs:string"></xs:element>
                           <xs:element name="PracticeLocationAddressFaxNumber"></xs:element>
                           <xs:element name="EnumerationDate" type="xs:string"></xs:element>
                           <xs:element name="LastUpdateDate" type="xs:string"></xs:element>
                           <xs:element name="NPIDeactivationReasonCode"></xs:element>
                           <xs:element name="NPIDeactivationReason"></xs:element>
                           <xs:element name="NPIDeactivationDate"></xs:element>
                           <xs:element name="NPIReactivationDate"></xs:element>
                           <xs:element name="GenderCode" type="xs:string"></xs:element>
                           <xs:element name="Gender" type="xs:string"></xs:element>
                           <xs:element name="AuthorizedOfficialLastName"></xs:element>
                           <xs:element name="AuthorizedOfficialFirstName"></xs:element>
                           <xs:element name="AuthorizedOfficialMiddleName"></xs:element>
                           <xs:element name="AuthorizedOfficialTitle"></xs:element>
                           <xs:element name="AuthorizedOfficialNamePrefix"></xs:element>
                           <xs:element name="AuthorizedOfficialNameSuffix"></xs:element>
                           <xs:element name="AuthorizedOfficialCredential"></xs:element>
                           <xs:element name="AuthorizedOfficialTelephoneNumber"></xs:element>
                           <xs:element name="Taxonomies">
                                 <xs:complexType>
                                       <xs:sequence>
                                             <xs:element name="Taxonomy" maxOccurs="unbounded">
                                                   <xs:complexType>
                                                         <xs:sequence>
                                                               <xs:element name="TaxonomyCode" type="xs:string"></xs:element>
                                                               <xs:element name="TaxonomyName" type="xs:string"></xs:element>
                                                               <xs:element name="LicenseNumber" type="xs:string"></xs:element>
                                                               <xs:element name="LicenseNumberStateCode" type="xs:string"></xs:element>
                                                               <xs:element name="PrimaryTaxonomySwitch" type="xs:string"></xs:element>
                                                         </xs:sequence>
                                                   </xs:complexType>
                                             </xs:element>
                                       </xs:sequence>
                                 </xs:complexType>
                           </xs:element>
                           <xs:element name="OtherIdentifiers">
                                 <xs:complexType>
                                       <xs:sequence>
                                             <xs:element name="OtherIdentifier" maxOccurs="unbounded">
                                                   <xs:complexType>
                                                         <xs:sequence>
                                                               <xs:element name="OtherIdentifierName" type="xs:string"></xs:element>
                                                               <xs:element name="OtherIdentifierType" type="xs:string"></xs:element>
                                                               <xs:element name="OtherIdentifierState" type="xs:string"></xs:element>
                                                               <xs:element name="OtherIdentifierIssuer"></xs:element>
                                                         </xs:sequence>
                                                   </xs:complexType>
                                             </xs:element>
                                       </xs:sequence>
                                 </xs:complexType>
                           </xs:element>
                           <xs:element name="HealthcareProviderTaxonomyGroups"></xs:element>
                     </xs:sequence>
               </xs:complexType>
         </xs:element>
   </xs:schema>

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