Clairemont Family Medical Clinic
LBN: San Diego Primary Care Medical Group
Clairemont Family Medical Clinic is an health care organization with primary practice located at 3737 Moraga Ave Ste B408, San Diego CA 92117-5364. The organization recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Adult Medicine, Ambulatory Health Care Facilities / Primary Care. Allopathic & Osteopathic Physicians / Adult Medicine is the primary health care specialty.
San Diego Primary Care Medical Group can be contacted via phone (858) 292-8885, or through Boone, Gary Kenneth 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:
Authorized official contact:
Name: Boone, Gary Kenneth Doctor of Medicine (MD)
Phone: (858) 292-8885
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Adult Medicine | 207QA0505X | G31968 | California |
| Ambulatory Health Care Facilities / Primary Care | 261QP2300X |
Profile Details
| NPI number | 1932257193 |
|---|---|
| LBN Legal business name | San Diego Primary Care Medical Group |
| DBA Doing business as | Clairemont Family Medical Clinic |
| Authorized official | Boone, Gary Kenneth Doctor of Medicine (MD) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Jan 6th, 2007 |
| Last updated | Nov 12th, 2020 - about 5 years ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1932257193 | NPPES |
| California | MEDICAID | 00G319680 |
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