| La Maestra Family Clinic | |
|
4060 Fairmount Ave San Diego CA 92105-1609 | |
| (619) 584-1612 | |
| Not Available |
| Full Name | La Maestra Family Clinic |
|---|---|
| Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
| Location | 4060 Fairmount Ave, San Diego, California |
| Authorized Official Name and Position | Zara Marselian (CEO) |
| Authorized Official Contact | 6195841612 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| La Maestra Family Clinic 4060 Fairmount Ave San Diego CA 92105-1609 Ph: (619) 584-1612 | La Maestra Family Clinic 4060 Fairmount Ave San Diego CA 92105-1609 Ph: (619) 584-1612 |
| NPI Number | 1124205430 |
|---|---|
| Provider Enumeration Date | 01/29/2008 |
| Last Update Date | 09/16/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124205430 | NPI | - | NPPES |
| EAP00011F | Other | CA | EAPC PROVIDER NUMBER |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | 090000378 (California) | Primary |
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