Organization
LA MAESTRA FAMILY CLINIC INC.
Active
Other names
La Maestra Community Health Centers
Organization subpart
No
Provider details
NPI number
Authorized official
TOM VU (CHIEF OF RISK MANAGEMENT)
(619) 972-4165
Entity
Organization
Contact information
Practice address
181 REA AVE, EL CAJON, CA 92020-3985
(619) 584-1612
Mailing address
4060 FAIRMOUNT AVE, SAN DIEGO, CA 92105-1608
(619) 584-1612
Taxonomy
Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
FHC70472G
—
CA
Enumeration date
11/03/2020
Last updated
11/03/2020
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