| La Maestra Family Clinic, Inc. | |
|
4060 Fairmount Ave San Diego CA 92105-1608 | |
| (619) 280-4213 | |
| (619) 281-6738 |
| Full Name | La Maestra Family Clinic, Inc. |
|---|---|
| Speciality | Clinic/Center |
| Location | 4060 Fairmount Ave, San Diego, California |
| Authorized Official Name and Position | Zara Marselian (CEO) |
| Authorized Official Contact | 6199610818 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| La Maestra Family Clinic, Inc. 4060 Fairmount Ave San Diego CA 92105-1608 Ph: (619) 961-0818 | La Maestra Family Clinic, Inc. 4060 Fairmount Ave San Diego CA 92105-1608 Ph: (619) 280-4213 |
| NPI Number | 1609849074 |
|---|---|
| Provider Enumeration Date | 02/08/2006 |
| Last Update Date | 12/07/2021 |
| Medicare PECOS PAC ID | 7113968512 |
|---|---|
| Medicare Enrollment ID | O20070206000747 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1609849074 | NPI | - | NPPES |
| FHC70472G | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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