| NPI | 1114497658 |
|---|---|
| Doing Business As | GOGOGRANDPARENT |
| Entity Type | Organization |
| Authorized Contact | JUSTIN BOOGAARD Owner/CEO 619-917-5091 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RG0300X Internal Medicine, Geriatric Medicine |
| Additional Taxonomies | 207QG0300X Family Medicine, Geriatric Medicine |
| 2084N0400X Psychiatry & Neurology, Neurology | |
| 2084P0800X Psychiatry & Neurology, Psychiatry | |
| 2084P0805X | |
| 251E00000X Home Health | |
| Enumeration Date | 2018-11-27 |
| Last Update Date | 2024-03-25 |