| NPI | 1932257193 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GARY KENNETH BOONE President 858-292-8885 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QA0505X Family Medicine Adult Medicine (Licence: CA G31968) |
| Additional Taxonomies | 261QP2300X Clinic/Center Primary Care |
| Enumeration Date | 2007-01-06 |
| Last Update Date | 2024-11-11 |