# LA MAESTRA FAMILY CLINIC, INC.

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- **Entity:** Organization
- **Status:** Active
- **Other names:** La Maestra Seldovia Clinic
- **Organization subpart:** No

## Provider details

- **NPI number:** 1912301110
- **Authorized official:** TOM VU (DIRECTOR OF CORPORATE COMPLIANCE)
- **Authorized official phone:** (619) 269-1292

## Contact information

- **Practice address:** 259 SELDOVIA STREET,, BOX 206, SELDOVIA, AK 99663-0206
- **Practice address phone:** (907) 234-7825
- **Practice address fax:** (907) 234-7825
- **Mailing address:** 4060 FAIRMOUNT AVE, SAN DIEGO, CA 92105-1608
- **Mailing address phone:** (619) 584-1612
- **Mailing address fax:** (619) 281-6738

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |
| 363A00000X | Physician Assistant | 1011073 | AK | — |
| 363L00000X | Nurse Practitioner | 1011073 | AK | — |

## Other

- **Enumeration date:** 10/16/2014
- **Last updated:** 09/01/2016