# SAN DIEGO PRIMARY CARE MEDICAL GROUP

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Clairemont Family Medical Clinic
- **Organization subpart:** No

## Provider details

- **NPI number:** 1932257193
- **Authorized official:** GARY KENNETH BOONE M.D. (PRESIDENT)
- **Authorized official phone:** (858) 292-8885

## Contact information

- **Practice address:** 3737 MORAGA AVE, STE B408, SAN DIEGO, CA 92117-5364
- **Practice address phone:** (858) 292-8885
- **Practice address fax:** (858) 292-0688
- **Mailing address:** 3737 MORAGA AVE, STE B408, SAN DIEGO, CA 92117-5364
- **Mailing address phone:** (858) 292-8885
- **Mailing address fax:** (858) 292-0688

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207QA0505X | Adult Medicine Physician | G31968 | CA | Yes |
| 261QP2300X | Primary Care Clinic/Center | — | NULL | — |

## Other

- **Enumeration date:** 01/06/2007
- **Last updated:** 11/11/2024