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CH09544AG LA MAESTRA FAMILY CLINIC, INC. (Active)
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Main Details
Name
LA MAESTRA FAMILY CLINIC, INC.
Subdivision Name
La Maestra City Heights Clinic
Type
HRSA-Funded Health Center
Site ID
BPS-H80-030578
340B ID
CH09544AG
Grant Number
H80CS00812
Additional Details
Current Program Status
Active
Registration Date
11/21/2023
Participating Start Date
1/1/2024
Participating Approval Date
11/27/2023
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
4074 Fairmount Ave
San Diego, CA 92105-1608
Billing Address
La Maestra Community Health Centers
4060 Fairmount Avenue
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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