| La Maestra Community Health Centers | |
|
165 South First Street El Cajon CA 92019 | |
| (619) 312-0347 | |
| (619) 749-5480 |
| Full Name | La Maestra Community Health Centers |
|---|---|
| Speciality | Clinic/Center |
| Location | 165 South First Street, El Cajon, California |
| Authorized Official Name and Position | Zara Marselian (CEO) |
| Authorized Official Contact | 6195841612 |
| 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 Avenue San Diego CA 92105 Ph: (619) 280-1105 | La Maestra Community Health Centers 165 South First Street El Cajon CA 92019 Ph: (619) 312-0347 |
| NPI Number | 1306929443 |
|---|---|
| Provider Enumeration Date | 10/23/2006 |
| Last Update Date | 12/07/2021 |
| Medicare PECOS PAC ID | 7113968512 |
|---|---|
| Medicare Enrollment ID | O20050516000901 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1306929443 | NPI | - | NPPES |
| BCP71086F | Other | CA | CDP PROVIDER NUMBER |
| FHC71086F | Medicaid | CA | |
| EAP00011F | Other | CA | EAPC PROVIDER NUMBER |
| HAP71086F | Other | CA | SOFP PROVIDER NUMBER |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
| Provider Name | Desdemona B Whitley |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1598533911 PECOS PAC ID: 2466345574 Enrollment ID: I20040203000985 |
| Provider Name | Mumtaz T Almansour |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1558567446 PECOS PAC ID: 5698753952 Enrollment ID: I20040712001620 |
| Provider Name | Aliya I Khan |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1285687350 PECOS PAC ID: 2961458021 Enrollment ID: I20050322001170 |
| Provider Name | Keith M Hourihan |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1306916994 PECOS PAC ID: 0749193670 Enrollment ID: I20050323000547 |
| Provider Name | Alex Kamsi |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1851405955 PECOS PAC ID: 7113974486 Enrollment ID: I20050407001263 |
| Provider Name | Ahmed K El-ghoneimy |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1942257852 PECOS PAC ID: 1153318811 Enrollment ID: I20060427000160 |
| Provider Name | Daniel M Galant |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1174614515 PECOS PAC ID: 8224035738 Enrollment ID: I20061025000769 |
| Provider Name | Shaila Serpas |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1124039136 PECOS PAC ID: 6709885205 Enrollment ID: I20061211000509 |
| Provider Name | Cynthia Miranda |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1023186970 PECOS PAC ID: 6305941766 Enrollment ID: I20070508000527 |
| Provider Name | Jill Milton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598757270 PECOS PAC ID: 5193825123 Enrollment ID: I20070705000283 |
| Provider Name | Edward W Schumaker |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1184616872 PECOS PAC ID: 4587756903 Enrollment ID: I20070815000400 |
| Provider Name | Teri Kunin-rida |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1265580112 PECOS PAC ID: 4284714296 Enrollment ID: I20080103000373 |
| Provider Name | Maria Real |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548450471 PECOS PAC ID: 5496839516 Enrollment ID: I20080228000307 |
| Provider Name | Lance Fuchs |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1679612378 PECOS PAC ID: 6103996921 Enrollment ID: I20080605000750 |
| Provider Name | Robert G Gish |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1548281322 PECOS PAC ID: 2769482140 Enrollment ID: I20090114000521 |
| Provider Name | Sonia I Carbonell |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1902976343 PECOS PAC ID: 2466504014 Enrollment ID: I20090714000099 |
| Provider Name | Florentina M Ronquillo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376532531 PECOS PAC ID: 2961549720 Enrollment ID: I20091027000653 |
| Provider Name | Guillermo A Cantu-reyna |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1447389101 PECOS PAC ID: 6002945235 Enrollment ID: I20100527000152 |
| Provider Name | Steven M Haley |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1083764484 PECOS PAC ID: 5890827232 Enrollment ID: I20100720000636 |
| Provider Name | Hsun-hua Chou |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1346446713 PECOS PAC ID: 8820275415 Enrollment ID: I20110608000208 |
| Provider Name | Arika Johnson |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1821295585 PECOS PAC ID: 3870763048 Enrollment ID: I20110825000207 |
| Provider Name | Setareh S Jones |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1033441316 PECOS PAC ID: 6709050057 Enrollment ID: I20111122000679 |
| Provider Name | Andrew J Gellens |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1164528741 PECOS PAC ID: 8123209780 Enrollment ID: I20120223000810 |
| Provider Name | Michael S Gibson |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1447246640 PECOS PAC ID: 4385646074 Enrollment ID: I20120607000218 |
| Provider Name | Todd M Larocque |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1225140288 PECOS PAC ID: 7113924911 Enrollment ID: I20120628000355 |
| Provider Name | Mylien Vu Ho |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1851464606 PECOS PAC ID: 4284889809 Enrollment ID: I20130306000184 |
| Provider Name | David William Cline |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1922162015 PECOS PAC ID: 5698808889 Enrollment ID: I20130325000475 |
| Provider Name | Payam P Sazegar |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1750623716 PECOS PAC ID: 5799921540 Enrollment ID: I20130423000327 |
| Provider Name | Dora Doan |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1003129834 PECOS PAC ID: 8426295783 Enrollment ID: I20130506000513 |
| Provider Name | Javier Rodriguez |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1013059385 PECOS PAC ID: 4880831833 Enrollment ID: I20130510000118 |
| Provider Name | Roula Soufi Adjan |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1992847263 PECOS PAC ID: 0042457095 Enrollment ID: I20130510000134 |
| Provider Name | Rachel A Abbott |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1548557903 PECOS PAC ID: 7911120019 Enrollment ID: I20140517000194 |
| Provider Name | Mario L Salguero Galland |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1487947826 PECOS PAC ID: 4880816479 Enrollment ID: I20141114002277 |
| Provider Name | Arij Faksh |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1912166737 PECOS PAC ID: 8224284823 Enrollment ID: I20160217002421 |
| Provider Name | Alesandra N Ilchena |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1871046664 PECOS PAC ID: 6305134362 Enrollment ID: I20161007000880 |
| Provider Name | Rami Y Michael |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1467871673 PECOS PAC ID: 6204115835 Enrollment ID: I20171003004958 |
| Provider Name | Pamela V Lam |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1235540964 PECOS PAC ID: 0042576563 Enrollment ID: I20171115002870 |
| Provider Name | Zsa Zsa A Sweeney |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003159344 PECOS PAC ID: 1759640154 Enrollment ID: I20180110001871 |
| Provider Name | Judith Aness Costa |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1932696960 PECOS PAC ID: 4486909447 Enrollment ID: I20180614001530 |
| Provider Name | Diana P Alvarez |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1013200617 PECOS PAC ID: 3072869957 Enrollment ID: I20180706001966 |
| Provider Name | Irene Nevarez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003166646 PECOS PAC ID: 5294077210 Enrollment ID: I20190423001663 |
| Provider Name | Martha Jasso-ramirez |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1871772020 PECOS PAC ID: 7214279868 Enrollment ID: I20190430002440 |
| Provider Name | Wasim Mansour |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1649627696 PECOS PAC ID: 0547593667 Enrollment ID: I20190605000441 |
| Provider Name | Zain T Jabri |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1891159620 PECOS PAC ID: 7719221241 Enrollment ID: I20191112002520 |
| Provider Name | Belinda A Akakpo Maxwell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477108470 PECOS PAC ID: 9032543533 Enrollment ID: I20191216001458 |
| Provider Name | Ramiz Sabri Putrus |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1144300534 PECOS PAC ID: 9537179494 Enrollment ID: I20200103002088 |
| Provider Name | Kavita P Deshpande |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1467715748 PECOS PAC ID: 1759679434 Enrollment ID: I20200130000708 |
| Provider Name | Rachel Stones |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1720583040 PECOS PAC ID: 4486046224 Enrollment ID: I20220127002634 |
| Provider Name | Jennifer M Renzas |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1225512759 PECOS PAC ID: 2668725961 Enrollment ID: I20220207001953 |
| Provider Name | Miriam J Cardenas |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457027005 PECOS PAC ID: 9032507868 Enrollment ID: I20220210002175 |
| Provider Name | Sandra Bahena-colley |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1073742268 PECOS PAC ID: 5294128260 Enrollment ID: I20220215002610 |
| Provider Name | David Mansour |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1689164949 PECOS PAC ID: 4981936200 Enrollment ID: I20220218000889 |
| Provider Name | Stephanie E Cone |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1437444858 PECOS PAC ID: 3577957190 Enrollment ID: I20220224002559 |
| Provider Name | Claudia Montenegro |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1376098251 PECOS PAC ID: 5496029357 Enrollment ID: I20220303001789 |
| Provider Name | Samantha Goggin |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1023506367 PECOS PAC ID: 3870987803 Enrollment ID: I20220308001313 |
| Provider Name | Alba Casco |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689066490 PECOS PAC ID: 3870988413 Enrollment ID: I20220318000304 |
| Provider Name | Erin L Suhir |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528426947 PECOS PAC ID: 3870858012 Enrollment ID: I20220324001085 |
| Provider Name | Jennifer H Fine |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1154094415 PECOS PAC ID: 9133527021 Enrollment ID: I20220325000783 |
| Provider Name | Claudia Castelnovi |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1417279324 PECOS PAC ID: 1254626468 Enrollment ID: I20220330000907 |
| Provider Name | Christine Y Lin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316221690 PECOS PAC ID: 7315226800 Enrollment ID: I20220411000369 |
| Provider Name | Ana Karen Ortiz Ilizaliturri |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1316407026 PECOS PAC ID: 6901281831 Enrollment ID: I20220913004136 |
| Provider Name | Ayser Saad Mahmood Al-mshhdani |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1679008569 PECOS PAC ID: 3274878434 Enrollment ID: I20230201000375 |
| Provider Name | Pejman Behin |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1568037984 PECOS PAC ID: 8426416769 Enrollment ID: I20230620000924 |
| Provider Name | Sapna A Dharkar Surber |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538707765 PECOS PAC ID: 0345670196 Enrollment ID: I20240102004097 |
| Provider Name | Priya Reddy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700435211 PECOS PAC ID: 1951752500 Enrollment ID: I20240108004079 |
| Provider Name | Sue Elaine Dorado |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1518481407 PECOS PAC ID: 3476905233 Enrollment ID: I20240117001516 |
| Provider Name | Loraine Meraz Gutierrez |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1093863029 PECOS PAC ID: 0143449108 Enrollment ID: I20240123001346 |
| Provider Name | Thuy Tien Pham |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689292914 PECOS PAC ID: 1153764402 Enrollment ID: I20240205000101 |
| Provider Name | John Kuek |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1447551353 PECOS PAC ID: 9234524059 Enrollment ID: I20240219001226 |
| Provider Name | Marisa Carolina Boelk |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1083733398 PECOS PAC ID: 8820433311 Enrollment ID: I20240223002014 |
| Provider Name | Cristina L Kim |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780233098 PECOS PAC ID: 0143666941 Enrollment ID: I20240315000529 |
| Provider Name | Mya Theda Kyi |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619754025 PECOS PAC ID: 1850739798 Enrollment ID: I20240410003631 |
Health Ave Clinic Inc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 250 E Chase Ave Ste 109, El Cajon, CA 92020 Phone: 619-499-5006 | |
Zion Healing Center Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 330 S Magnolia Ave Ste 203, El Cajon, CA 92020 Phone: 619-350-0302 | |
Ahmed Alshawwaf Md Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 330 S Magnolia Ave Ste 101, El Cajon, CA 92020 Phone: 619-383-4153 | |
Mumtoy Al Mansous Md Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 330 S. Magnolia Ave. Suite 101, El Cajon, CA 92020 Phone: 619-861-4123 Fax: 858-676-0035 | |
Chase Avenue Family Health Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1111 W Chase Ave, El Cajon, CA 92020 Phone: 619-515-2300 Fax: 619-593-9164 | |
Salam Yatooma, M.d., Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2030 Colina Grande, El Cajon, CA 92019 Phone: 619-729-0559 Fax: 619-740-4204 | |
Chase Avenue Family Health Center Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1111 W Chase Ave, El Cajon, CA 92020 Phone: 619-515-2499 Fax: 619-593-9164 |