Provider Demographics
NPI:1083639025
Name:GOLDFARB, PAUL MICHAEL (MD)
Entity Type:Individual
Prefix:DR
First Name:PAUL
Middle Name:MICHAEL
Last Name:GOLDFARB
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:3075 HEALTH CENTER DR
Mailing Address - Street 2:SUITE 102
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92123-2773
Mailing Address - Country:US
Mailing Address - Phone:858-637-7888
Mailing Address - Fax:858-637-7887
Practice Address - Street 1:3075 HEALTH CENTER DR
Practice Address - Street 2:SUITE 102
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92123-2773
Practice Address - Country:US
Practice Address - Phone:858-637-7888
Practice Address - Fax:858-637-7887
Is Sole Proprietor?:No
Enumeration Date:2006-07-12
Last Update Date:2009-01-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAG381362086X0206X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086X0206XAllopathic & Osteopathic PhysiciansSurgerySurgical Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA47372Medicare UPIN
CAG38136Medicare PIN