SAN DIEGO PRIMARY CARE MEDICAL GROUP NPI 1932257193

NPI Information

NPI: 1932257193
Provider Name: SAN DIEGO PRIMARY CARE MEDICAL GROUP

Doing Business As: CLAIREMONT FAMILY MEDICAL CLINIC

Classification: Family Medicine - 207QA0505X
Entity Type: Organization

Specialization: Adult Medicine

Address:
3737 MORAGA AVE
STE B408
SAN DIEGO, CA
ZIP 92117
Phone: (858) 292-8885
Get Directions

SAN DIEGO PRIMARY CARE MEDICAL GROUP is an adult medicine family medicine in San Diego, CA. The provider is definition to come. SAN DIEGO PRIMARY CARE MEDICAL GROUP NPI is 1932257193. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Clairemont Family Medical Clinic.

The provider's business location address is:

3737 MORAGA AVE
STE B408
SAN DIEGO, CA
ZIP 92117-364
Phone: (858) 292-8885
Fax: (858) 292-0688

The provider's authorized official is Gary Kenneth Boone .
The authorized official title is President and has the following contact phone number (858) 292-8885.

The CLIA number assigned to this NPI record is 05D0891063 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 1/6/2007 and was last updated on 11/12/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	207QA0505X	Family Medicine	Adult Medicine	G31968	CALIFORNIA	Yes
2	261QP2300X	Clinic/Center	Primary Care			No

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	00G319680	MEDICAID	CALIFORNIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.

« Previous NPI

Next NPI »