MEDICARE: CARLY GOODING PA-C

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	363A00000X	Physician Assistant

General Provider Information

NPI Number	:	1447002506
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CARLY GOODING PA-C

Provider Business Mailing Address
First Line	:	142 SADDLE RIDGE DR
Second Line	:
City	:	ALEXANDER
State	:	NC
Zip	:	28701-0106
Country	:	US
Telephone Number	:	214-532-2039
Fax Number	:

Provider Business Practice Location Address
First Line	:	1040 CARLSBAD VILLAGE DR STE 106
Second Line	:
City	:	CARLSBAD
State	:	CA
Zip	:	92008-1981
Country	:	US
Telephone Number	:	442-427-2474
Fax Number	:

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

Provider Enumeration Date	:	04/03/2024
Last Update Date	:	02/16/2026

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Directions to “ CARLY GOODING PA-C” Practice Location

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