| La Maestra Community Health Centers | |
|
1032 Broadway El Cajon CA 92021-7416 | |
| (619) 584-1612 | |
| Not Available |
| Full Name | La Maestra Community Health Centers |
|---|---|
| Speciality | Clinic/Center |
| Location | 1032 Broadway, El Cajon, California |
| Authorized Official Name and Position | Tom Vu (DIRECTOR OF RISK AND COMPLIANCE) |
| Authorized Official Contact | 6192691292 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| La Maestra Community Health Centers 4060 Fairmount Ave San Diego CA 92105-1608 Ph: (619) 584-1612 | La Maestra Community Health Centers 1032 Broadway El Cajon CA 92021-7416 Ph: (619) 584-1612 |
| NPI Number | 1134590086 |
|---|---|
| Provider Enumeration Date | 10/16/2015 |
| Last Update Date | 10/16/2015 |
| Medicare PECOS PAC ID | 7113968512 |
|---|---|
| Medicare Enrollment ID | O20161010000296 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1134590086 | NPI | - | NPPES |
| CMCSUB5E3 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | 090000378 (California) | Primary |
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