Organization
LA MAESTRA FAMILY CLINIC, INC.
Active
Other names
LA MAESTRA COMMUNITY PHARMACY EL CAJON
Organization subpart
No
Provider details
NPI number
Authorized official
TOM VU (DIRECTOR OF CORPORATE COMPLIANCE)
(619) 972-4165
Entity
Organization
Contact information
Practice address
165 S 1ST ST STE 1B, EL CAJON, CA 92019-4795
(619) 584-1612
Mailing address
4060 FAIRMOUNT AVE, SAN DIEGO, CA 92105-1608
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
55271
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
FHC70472G
—
CA
Enumeration date
06/19/2017
Last updated
06/19/2017
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