Organization
SAN DIEGO PRIMARY CARE MEDICAL GROUP
Active
Other names
Clairemont Family Medical Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
GARY KENNETH BOONE M.D. (PRESIDENT)
(858) 292-8885
Entity
Organization
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
261QP2300X
Primary Care Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G319680
—
CA
Enumeration date
01/06/2007
Last updated
11/11/2024
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