| La Maestra Seldovia Clinic | |
|
259 Seldovia Street, Box 206 Seldovia AK 99663-0206 | |
| (907) 234-7825 | |
| (907) 234-7825 |
| Full Name | La Maestra Seldovia Clinic |
|---|---|
| Speciality | Family Medicine |
| Location | 259 Seldovia Street,, Seldovia, Alaska |
| Authorized Official Name and Position | Tom Vu (DIRECTOR OF CORPORATE COMPLIANCE) |
| Authorized Official Contact | 6192691292 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| La Maestra Seldovia Clinic 4060 Fairmount Ave San Diego CA 92105-1608 Ph: (619) 584-1612 | La Maestra Seldovia Clinic 259 Seldovia Street, Box 206 Seldovia AK 99663-0206 Ph: (907) 234-7825 |
| NPI Number | 1912301110 |
|---|---|
| Provider Enumeration Date | 10/16/2014 |
| Last Update Date | 09/01/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1912301110 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| 363A00000X | Physician Assistant | 1011073 (Alaska) | Secondary |
| 363L00000X | Nurse Practitioner | 1011073 (Alaska) | Secondary |