Individual
DR. GARY KENNETH BOONE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3737 MORAGA AVE STE B408, SAN DIEGO, CA 92117-5364
(858) 292-8885
(858) 292-0688
Mailing address
3737 MORAGA AVE STE B408, SAN DIEGO, CA 92117-5364
(858) 292-8885
(858) 292-0688
Taxonomy
Speciality
Code
Description
License number
State
207QA0505X
Adult Medicine Physician
Primary
G31968
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G319680
—
CA
Enumeration date
07/05/2006
Last updated
11/19/2020
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