Organization
LA MAESTRA FAMILY CLINIC, INC.
Active
Other names
La Maestra Seldovia Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
TOM VU (DIRECTOR OF CORPORATE COMPLIANCE)
(619) 269-1292
Entity
Organization
Contact information
Practice address
259 SELDOVIA STREET,, BOX 206, SELDOVIA, AK 99663-0206
(907) 234-7825
(907) 234-7825
Mailing address
4060 FAIRMOUNT AVE, SAN DIEGO, CA 92105-1608
(619) 584-1612
(619) 281-6738
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
363A00000X
Physician Assistant
1011073
AK
363L00000X
Nurse Practitioner
1011073
AK
Other
Enumeration date
10/16/2014
Last updated
09/01/2016
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