NPIMap

Organization Active NPI

La Maestra Family Clinic, Inc.

  • Federally Qualified Health Center (FQHC)
  • San Diego, CA
National Provider Identifier
1750073086
Registry record updated May 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
LA MAESTRA FAMILY CLINIC, INC.
Practice address
4063 Polk Ave
San Diego, CA 92105-1436
Phone
(619) 584-1612
NPI assigned
May 24, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 24, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Tom Vu
Title
Executive Director
Phone
(619) 972-4165

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X Primary

Addresses

Primary practice location

4063 Polk Ave
San Diego, CA 92105-1436

Mailing address

4060 Fairmount Ave
San Diego, CA 92105-1608
Phone (619) 584-1612

Other names 1

  • La Maestra Community Health Centers Doing business as

National Provider Directory

National Provider Directory
Tax ID family
La Maestra Family Clini40 organizations share this tax ID, including this one

Other organizations with this tax ID 39

Organizations that report the same tax identification number in the National Provider Directory.

View all 39

Locations

4063 Polk Ave
San Diego, CA 92105
Phone (619) 344-6120

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1684886400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1684886400000",
    "number": "1750073086",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4060 FAIRMOUNT AVE",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921051608",
            "telephone_number": "619-584-1612"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4063 POLK AVE",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921051436",
            "telephone_number": "619-584-1612"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LA MAESTRA FAMILY CLINIC, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-05-24",
        "last_updated": "2023-05-24",
        "certification_date": "2023-05-06",
        "status": "A",
        "authorized_official_last_name": "VU",
        "authorized_official_first_name": "TOM",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "619-972-4165"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "La Maestra Community Health Centers",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.