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Organization

LA MAESTRA FAMILY CLINIC

Active
Other names
LA MAESTRA FAMILY COMMUNITY HEALTH CENTERS
Organization subpart
No

Provider details

NPI number
Authorized official
ZARA MARSELIAN (CEO)
(619) 584-1612
Entity
Organization

Contact information

Practice address
4060 FAIRMOUNT AVE, SAN DIEGO, CA 92105-1609
(619) 584-1612
Mailing address
4060 FAIRMOUNT AVE, SAN DIEGO, CA 92105-1609
(619) 584-1612

Taxonomy

Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
090000378
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
EAP00011F
EAPC PROVIDER NUMBER
CA
Enumeration date
01/29/2008
Last updated
09/16/2010
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