Dr. Gary Kenneth Boone
Family Doctor - Adult Medicine
3737 Moraga Ave Ste B408
San Diego
, California 92117-5364
Dr. Gary Kenneth Boone
Family Doctor - Adult Medicine
3737 Moraga Ave Ste B408
San Diego
, California 92117-5364
(858) 292-0688
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About
Features
Specialties
- Family Doctor - Adult Medicine
Languages spoken
- English
Location
First Address
- Dr. Gary Kenneth Boone
- 3737 Moraga Ave Ste B408
- San Diego, CA
- Zip : 92117-5364
- Fax : (858) 292-0688
- Phone : (858) 292-8885
Second Address
- Dr. Gary Kenneth Boone
- 3737 Moraga Ave Ste B408
- San Diego, CA
- Zip : 92117-5364
- Fax : (858) 292-0688
- Phone : (858) 292-8885
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 207QA0505X | Family Doctor - Adult Medicine | G31968 | CA |
National Provider Identifier
| NPI | 1073543781 |
|---|---|
| Provider Name | Dr. Gary Kenneth Boone |
| First Address | San Diego, CA 92117-5364 |
| Second Address | San Diego, CA 92117-5364 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 05/07/2006 |
| Last Update Date | 19/11/2020 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 00G319680 | (05) | CA |
| A44934 | (02) | CA |
| A44964 | (02) | CA |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.