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CH09544Y La Maestra Family Clinic, Inc. (Active)
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Main Details
Name
La Maestra Family Clinic, Inc.
Subdivision Name
LA MAESTRA LEMON GROVE CLINIC
Type
HRSA-Funded Health Center
Site ID
BPS-H80-009996
340B ID
CH09544Y
Grant Number
H80CS00812
Additional Details
Current Program Status
Active
Registration Date
12/12/2017
Participating Start Date
1/1/2018
Participating Approval Date
12/12/2017
Last Recertification Date
2/12/2025
Contacts
Authorizing Official
La Maestra Family Clinic, Inc.
ZARA MARSELIAN, CEO
(619) 584-1612 Ext: 3018
Primary Contact
La Maestra Family Clinic, Inc.
Tom Vu, Executive Director
(619) 972-4165
Addresses
Street Address
7967 Broadway
Lemon Grove, CA 91945-1809
Billing Address
La Maestra Family Clinic, Inc.
4060 Fairmount Avenue
San Diego, CA 92105-1608
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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Participating 7/1/2012 until terminated effective 4/1/2017, reinstated effective 1/1/2018
12/12/2017
5/24/12 - Reviewed registration and submitted to IS.
05/24/2012
May 2025
May 2025
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