Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086X0206X | Surgical Oncologist | G38136 | CA |
NPI | 1083639025 |
---|---|
Provider Name | Dr. Paul Michael Goldfarb |
First Address | San Diego, CA 92123-2773 |
Second Address | San Diego, CA 92123-2773 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/07/2006 |
Last Update Date | 12/01/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
A47372 | (02) | CA |