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General NPI Number Information
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NPI Number | 1063218865
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Entity Type | Organization
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Legal Business Name | GOODPATH MEDICAL PC
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Dates
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Enumeration Date | 02/21/2025
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Last Update Date | 02/21/2025
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Provider Practice Location Address
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Address Line | 110 CAMBRIDGE ST
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City | CAMBRIDGE
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State | MA
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Zip | 02141-1819
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Country | US
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Telephone | 949-463-0650
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Fax |
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Provider Business Mailing Address
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Address Line | 2180 VISTA WAY STE B
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City | OCEANSIDE
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State | CA
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Zip | 92054-5667
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | SABA HAQ
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Credential | MD
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Telephone | 949-463-0650
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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