MEDICARE: DR. DONALD OMAR FAREED M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207XX0005X	Sports Medicine (Orthopaedic Surgery) Physician	A23806	CA

General Provider Information

NPI Number	:	1013960848
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DONALD OMAR FAREED M.D.

Provider Business Mailing Address
First Line	:	PO BOX 50547
Second Line	:	1483 EAST VALLEY ROAD STE. 19
City	:	SANTA BARBARA
State	:	CA
Zip	:	93150-0547
Country	:	US
Telephone Number	:	805-969-0988
Fax Number	:	805-969-6070

Provider Business Practice Location Address
First Line	:	1483 E VALLEY RD
Second Line	:
City	:	SANTA BARBARA
State	:	CA
Zip	:	93108-1249
Country	:	US
Telephone Number	:	805-969-0988
Fax Number	:	805-969-6070

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/19/2006
Last Update Date	:	07/08/2007

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