Provider Demographics
NPI:1528035375
Name:GOODSON, FOLAYAN IFE (MD)
Entity Type:Individual
Prefix:DR
First Name:FOLAYAN
Middle Name:IFE
Last Name:GOODSON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3252 RANCHO COMPANERO
Mailing Address - Street 2:
Mailing Address - City:CARLSBAD
Mailing Address - State:CA
Mailing Address - Zip Code:92009-2200
Mailing Address - Country:US
Mailing Address - Phone:760-431-1153
Mailing Address - Fax:
Practice Address - Street 1:2212 S EL CAMINO REAL
Practice Address - Street 2:SUITE 100
Practice Address - City:OCEANSIDE
Practice Address - State:CA
Practice Address - Zip Code:92054-6368
Practice Address - Country:US
Practice Address - Phone:760-754-0974
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-01
Last Update Date:2008-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA86779207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine