Theodore George Goldfarab, M.D.

Primary specialty

Anatomic Pathology PhysicianTaxonomy code 207ZP0101X

License

022043 Issued in OH

Practice address

1188 Sea Larke Dr
Fallbrook, CA 92028-4453

Phone

(760) 695-8946

Fax

(760) 723-8946

NPI assigned

Jan 16, 2007

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Feb 22, 2016 through Feb 22, 2028

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1168905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1770634669",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1188 SEA LARKE DR",
            "city": "FALLBROOK",
            "state": "CA",
            "postal_code": "920284453",
            "telephone_number": "760-723-8946",
            "fax_number": "760-723-8946"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1188 SEA LARKE DR",
            "city": "FALLBROOK",
            "state": "CA",
            "postal_code": "920284453",
            "telephone_number": "760-695-8946",
            "fax_number": "760-723-8946"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLDFARAB",
        "first_name": "THEODORE",
        "middle_name": "GEORGE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0101X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology",
            "state": "OH",
            "license": "022043",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Anatomic Pathology Physician in Fallbrook, CA
• Providers in Fallbrook, CA by specialty
• Anatomic Pathology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.