Organization
LA MAESTRA FAMILY CLINIC, INC.
Active
Other names
La Maestra Community Health Centers
Organization subpart
No
Provider details
NPI number
Authorized official
MS. ZARA MARSELIAN (CEO)
(619) 584-1612
Entity
Organization
Contact information
Practice address
165 SOUTH FIRST STREET, EL CAJON, CA 92019
(619) 312-0347
(619) 749-5480
Mailing address
4060 FAIRMOUNT AVENUE, SAN DIEGO, CA 92105
(619) 280-1105
(619) 281-6738
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
BCP71086F
CDP PROVIDER NUMBER
CA
01
—
EAP00011F
EAPC PROVIDER NUMBER
CA
05
—
FHC71086F
—
CA
01
—
HAP71086F
SOFP PROVIDER NUMBER
CA
Enumeration date
10/23/2006
Last updated
12/07/2021
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