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CH09544AA La Maestra Family Clinic, Inc. (Terminated)
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Main Details
Name
La Maestra Family Clinic, Inc.
Subdivision Name
La Maestra Lemon Grove Dental Clinic
Type
HRSA-Funded Health Center
Site ID
BPS-H80-019344
340B ID
CH09544AA
Grant Number
H80CS00812
Additional Details
Current Program Status
Terminated
Registration Date
12/12/2017
Participating Start Date
1/1/2018
Participating Approval Date
12/12/2017
Last Recertification Date
2/1/2024
Termination Date
Termination Reason
4/1/2025
Business decision by the Covered Entity
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
7139 Broadway
Lemon Grove, CA 91945-9194
Billing Address
La Maestra Family Clinic, Inc.
4060 Fairmount Ave
San Diego, CA 92105
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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May 2025
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