Organization
LA MAESTRA FAMILY CLINIC INC
Active
Organization
LA MAESTRA FAMILY CLINIC INC
Active
Other names
La Maestra Community Health Centers
Organization subpart
No
Provider details
NPI number
Authorized official
MR. TOM VU (DIRECTOR OF RISK AND COMPLIANCE)
(619) 269-1292
Entity
Organization
Contact information
Practice address
1032 BROADWAY, EL CAJON, CA 92021-7416
(619) 584-1612
Mailing address
4060 FAIRMOUNT AVE, SAN DIEGO, CA 92105-1608
(619) 584-1612
(619) 281-6738
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
090000378
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
CMCSUB5E3
—
CA
Enumeration date
10/16/2015
Last updated
10/16/2015
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