| San Diego Primary Care Medical Group | |
|
3737 Moraga Ave Ste B408 San Diego CA 92117-5364 | |
| (858) 292-8885 | |
| (858) 292-0688 |
| Full Name | San Diego Primary Care Medical Group |
|---|---|
| Speciality | Family Medicine |
| Location | 3737 Moraga Ave, San Diego, California |
| Authorized Official Name and Position | Gary Kenneth Boone (PRESIDENT) |
| Authorized Official Contact | 8582928885 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| San Diego Primary Care Medical Group 3737 Moraga Ave Ste B408 San Diego CA 92117-5364 Ph: (858) 292-8885 | San Diego Primary Care Medical Group 3737 Moraga Ave Ste B408 San Diego CA 92117-5364 Ph: (858) 292-8885 |
| NPI Number | 1932257193 |
|---|---|
| Provider Enumeration Date | 01/06/2007 |
| Last Update Date | 11/11/2024 |
| Medicare PECOS PAC ID | 5193755254 |
|---|---|
| Medicare Enrollment ID | O20050817001223 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1932257193 | NPI | - | NPPES |
| 00G319680 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Secondary |
| 207QA0505X | Family Medicine - Adult Medicine | G31968 (California) | Primary |
| Provider Name | Gary K Boone |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1073543781 PECOS PAC ID: 6002846169 Enrollment ID: I20120627000425 |
Stephen M. Daquino, Do; Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 16445 Bernardo Center Dr, San Diego, CA 92128 Phone: 858-429-0099 Fax: 858-676-1172 | |
Nucleus Medical Group Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 4570 Executive Dr Ste 100, San Diego, CA 92121 Phone: 844-838-3322 | |
Moden Medical Group Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 8901 Activity Rd Ste 205, San Diego, CA 92126 Phone: 888-822-1184 Fax: 888-877-3676 | |
Aldiwani Medical Group Corporation Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 11409 Windy Summit Pl, San Diego, CA 92127 Phone: 832-371-3279 Fax: 619-939-4556 | |
Azam Md & Mcjunkin Prof Corp Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 3455 Ingraham St, San Diego, CA 92109 Phone: 619-937-2055 | |
Presidio Medical Group Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 4440 Lamont St, San Diego, CA 92109 Phone: 858-270-7633 Fax: 858-270-7692 | |
Michael L Butera Md Inc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 6699 Alvarado Rd Ste 2309, San Diego, CA 92120 Phone: 619-286-8803 Fax: 619-286-2344 |