Organization
LA MAESTRA FAMILY CLINIC
Active
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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