Boone, Gary Kenneth

Boone, Gary Kenneth is an individual health care provider with primary practice located at 3737 Moraga Ave Ste B408 , San Diego CA 92117-5364. He recently has only one registered license in Allopathic & Osteopathic Physicians / Adult Medicine, which is considered as his primary health care specialty. Boone, Gary Kenneth can be contacted via phone (858) 292-8885.

Contact Information

Primary practice address
3737 Moraga Ave Ste B408 San Diego CA 92117-5364
Phone: (858) 292-8885
Fax: (858) 292-0688
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Adult Medicine 207QA0505X G31968 California

Profile Details

NPI number 1073543781
LBN Legal business name Boone, Gary Kenneth
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 5th, 2006
Last updated Nov 19th, 2020 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1073543781 NPPES
California MEDICAID 00G319680

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