LA MAESTRA FAMILY CLINIC INC. NPI 1609849074

NPI Information

NPI: 1609849074
Provider Name: LA MAESTRA FAMILY CLINIC, INC.

Doing Business As: LA MAESTRA COMMUNITY HEALTH CENTERS

Classification: Clinic/Center - 261QF0400X
Entity Type: Organization

Specialization: Federally Qualified Health Center (FQHC)

Address:
4060 FAIRMOUNT AVE
SAN DIEGO, CA
ZIP 92105
Phone: (619) 280-4213
Get Directions

LA MAESTRA FAMILY CLINIC, INC. is a federally qualified health center (fqhc) clinic center in San Diego, CA. LA MAESTRA FAMILY CLINIC, INC. NPI is 1609849074. The provider is registered as an organization entity type.
The provider Is Doing Business As La Maestra Community Health Centers.

The provider's business location address is:

4060 FAIRMOUNT AVE
SAN DIEGO, CA
ZIP 92105-608
Phone: (619) 280-4213
Fax: (619) 281-6738

The provider's authorized official is Zara Marselian .
The authorized official title is Ceo and has the following contact phone number (619) 961-0818.

The enumeration date for this NPI number is 2/8/2006 and was last updated on 12/7/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QF0400X	Clinic/Center	Federally Qualified Health Center (FQHC)			Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	FHC70472G	MEDICAID	CALIFORNIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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